HomeMy WebLinkAboutWORK ACCEPTNACE FORM VELOCITY MARK ELECTRIC - 21-00355 - 7 E 2nd N - ShopContractor 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
Velocity Mark Electric
Destry Orr
City
Saint Anthony
State / Province / Region
ID
Postal / Zip Code
83445
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
406 W 2nd N
Address Line 2
velocitymarkco@gmail.com 2082214801
Electrical 032389 1/31/2022 10,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00355 Mark Kohler
7th East 2nd North
Acceptance
Sign 1/3/2022