HomeMy WebLinkAboutWORK AACEPTANCE FORM MARATHON ELECTRIC LLC - 19-00649 - Mountain View Clinic - RemodelContractor 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
Marathon Electric
J.D. Luke
City
MUrray
State / Province / Region
Utah
Postal / Zip Code
84107
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
6646 South Cottonwood St.
Address Line 2
jd.luke@marathonelectricllc.com 801-836-4658
Electrical ELE-C-32920 7/31/2021 $
Permit Information
Please enter in the following format: 00-00000
19-00649 Mountain View Clinic
404 North 2nd Ave Rexburg
Acceptance
Sign 11/6/2019