HomeMy WebLinkAboutWORK ACCEPTANCE FORM MOUNTAIN WEST ELECTRIC - 19-00256 - 2214 W 1000 S - Well House Buildings #9Contractor 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
Mountain West Electric, Inc
Dana Brown
City
Blackfoot
State / Province / Region
ID
Postal / Zip Code
83221
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
586 W Highway 26 #1
Address Line 2
dbrown@mtnwestelec.com 208.684.5463
Electrical ELE-C-3802 12/31/2020 389,000.00$
Permit Information
Please enter in the following format: 00-00000
19-00256 Well house #9
2214 W. 1000 S.
Acceptance
Sign 1/3/2020