HomeMy WebLinkAboutWORK ACCEPTANCE FORM MOUNTAIN VALLEY ELECTRIC - 23-00312 - 419 Violet St - Porch & AdditionContractor 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
Mountain Valley Electric
Marion Roundy
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
3880 E. 200 North
Address Line 2
Po Box 440
marion@mountainvalleyelectric.com 2082280775
Electrical 021047 10/31/2023 $
Permit Information
Please enter in the following format: 00-00000
23-00312 Juan Carreno
419 Violet Street Rexburg, ID 83440
Acceptance
Sign 9/7/2023