HomeMy WebLinkAboutWORK ACCEPTANCE FORM MOUNTAIN WEST ELECTRIC - 21-00471 - BYUI Romney Building - 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
MOUNTAIN WEST ELECTRIC - IDAHO
Courtney Solinsky
City
Blackfoot
State / Province / Region
ID
Postal / Zip Code
83221
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
586 West Highway 26 Box: 1
Address Line 2
coordinator@mtnwestelec.com (208)684-5463
Electrical ELE-C-3802 12/31/2021 130,600.00$
Permit Information
Please enter in the following format: 00-00000
21-00471 Romney Remodel
10 South 2nd East, Rexburg, ID 83460
Acceptance
Sign 6/24/2021