HomeMy WebLinkAboutWORK ACCEPTANCE FORM ELITE MECHANICAL - 21-00378 - Taco Bell - AdditionContractor 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
Elite Mechanical
Chad Nielson
City
Preston
State / Province / Region
Id
Postal / Zip Code
83263
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
17 Sunrise Dr.
Address Line 2
chad.elitemechanical@gmail.com 4358908262
Mechanical (HVAC)023248 7/31/2024 91,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00378 Taco Bell Remodel
22 west main
Acceptance
Sign 7/12/2021