HomeMy WebLinkAboutWORK ACCEPTANCE FORM FOR QUALITY HEATING - 19-00428 - 950 River Run - Gas LineContractor 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
Quality Heating Inc
Max Mora
City
IDAHO FALLS
State / Province / Region
ID
Postal / Zip Code
83402-4324
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
2130 S YELLOWSTONE HWY
Address Line 2
qh1@ifqualityheating.com 2085292093
Mechanical (HVAC)HVC-C-2591 11/30/2021 $
Permit Information
Please enter in the following format: 00-00000
19-00428 Jerry Muir
950 River Run
Acceptance
Sign 7/25/2019