HomeMy WebLinkAboutWORK ACCEPTANCE FORM MODERN PLUMBING, HEATING, & ELECTRIC - 21-00808 - 3372 Henry's Fork Way - MechanicalContractor 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Modern PHE
Jenni Garner
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83404
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
11187 N Moon Beam D
Address Line 2
office@Modernphe.com 208-745-7021
Mechanical (HVAC)012552 5/1/2024 $
Permit Information
Please enter in the following format: 00-00000
21-00808 Bruce Karren
3372 Henrys Fork Way
Acceptance
Sign 10/14/2021