HomeMy WebLinkAboutWORK ACCEPTANCE FORM PENA VENTURES - 23-00560 - Mountains Edge Sales & Services - RemodelContractor 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
Pena Ventures
Spencer Pena
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
2spena2@gmail.com 208-403-3040
Electrical 038799 3/31/2024 5,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00560 Mountain Edge Sales & Service - Remodel
4992 Eastside Dr
Acceptance
Sign 9/6/2023