HomeMy WebLinkAboutWORK ACCEPTANCE FORM B&S BOILER INC - 20-00248 - Vista Medical OfficeContractor 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
B & S Boiler, Inc
Kyle Anderson
City
Idaho Falls
State / Province / Region
Idaho
Postal / Zip Code
83402
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1555 W Sunnyside
Address Line 2
kylebsboiler@qwestoffice.net 208-524-1737
208-589-4157
Mechanical (HVAC)HVC-C-5115 11/30/2021 70,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00251 Vista Medical
576 Trejo
Acceptance
Sign 6/11/2020