HomeMy WebLinkAboutWORK ACCEPTANCE FORM EXCELLENCE HEATING & COOLING - 19-00136 - Romance Theater - Remodel Phase 1Contractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
Excellence Heating & Cooling
BRIAN DAVID MEDRAIN
City
IDAHO FALLS
State / Province / Region
ID
Postal / Zip Code
83402
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
480 N. Utah Ave
Address Line 2
excellencehtg@gmail.com 2088815058
2088211433
Mechanical (HVAC)009906 4/30/2022 55,800.00$
Permit Information
Please enter in the following format: 00-00000
19-00136 Romance theater
2 E main Street
Acceptance
Sign 5/29/2019