HomeMy WebLinkAboutWORK ACCEPTANCE FORM MARTINEAU ELECTRIC - 20-00862 - Deseret Industries - Yard EnclosureContractor 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
Martineau Electric
Ferron
City
Sugar City
State / Province / Region
ID
Postal / Zip Code
83448
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
474 S 3rd W
Address Line 2
Martineauelectric@msn.com 208-390-2126
Electrical C-25875 1/31/2022 $
Permit Information
Please enter in the following format: 00-00000
20-00862 D.I. Back room
611 N 2nd E Rexburg
Acceptance
Sign 4/13/2021