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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