HomeMy WebLinkAboutWORK ACCEPTANCE FORM MIKE WOOD HEATING & COOLING - 21-00237 - 156 N 2nd E - Shelfology BathroomContractor 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
mike wood heating and cooling
mike wood
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
mikewhvac@cableone.net 2083906669
Mechanical (HVAC)hvc-c2235 10/10/2022 600.00$
Permit Information
Please enter in the following format: 00-00000
21-00237 Shelfology Bathroom
156 N 2nd E
Acceptance
Sign 5/6/2021