HomeMy WebLinkAboutWORK ACCEPTANCE FORM INTERMOUNTAIN WIND & SOLAR - 22-00189 - 562 E 4th S - Solar PanelsContractor 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
Intermountain Wind and Solar
Kilee Russell
City
Centerville
State / Province / Region
UT
Postal / Zip Code
84014
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1041 N 950 W, Suite 500
Address Line 2
permitting@imwindandsolar.com 8012985255
Electrical RCE-35970 9/12/2022 16,863.00$
Permit Information
Please enter in the following format: 00-00000
22-00189 Lake PV Array
562 E 4th S, Rexburg, ID 83440
Acceptance
Sign 4/7/2022