HomeMy WebLinkAboutWORK ACCEPTANCE FORM VELOCITY MARK ELECTRIC - 23-00848 - Bear World - Jurassic Creek Gift 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
Update new contact information that is not already on file with the City of Rexburg
Street Address
1713 E 300 N
Address Line 2
velocitymarkco@gmail.com 2082214801
Electrical 032389 1/31/2024 30,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00848 Bear World
6010 S 4300 W Rexburg ID, 83440
Acceptance
Sign 12/1/2023