HomeMy WebLinkAboutWORK ACCEPTANCE FORM BRIAN MEYERS ELECTRIC - 19-00420 - Strobel Dentist Office - Solar PanelsContractor 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
Brian Meyers Electric
Brian Meyers
City
Sugar City
State / Province / Region
Idaho
Postal / Zip Code
83448
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
407 Buckskin Ct
Address Line 2
brian.meyers@bluemaxenergy.com 2082436701
Electrical ELE-M-23939 1/31/2020 9,240.00$
Permit Information
Please enter in the following format: 00-00000
19-00420 Strobel Dentist Office Solar Project
59 Professional Plaza
Acceptance
Sign 7/22/2019