HomeMy WebLinkAboutWORK ACCEPTNACE FORM BLUE MAX ENERGY - 21-00753 - 832 Oak Hill Cir - New SFRContractor 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
Blue Max Energy
Russell@bluemaxenergy.com
City
Ammon
State / Province / Region
Idaho
Postal / Zip Code
83406
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
3153 East 17th St
Address Line 2
russell@bluemaxenergy.com 2087097207
2087097207
Electrical 036781 8/31/2022 7,800.00$
Permit Information
Please enter in the following format: 00-00000
21-00753 El Nombre Del Proyecto
832 Oak Hill Cir
Acceptance
Sign 1/31/2022