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HomeMy WebLinkAboutWORK ACCEPTANCE FORM HIGH COUNTRY HEATING AND AIR CONDITIONING LLC - 22-00795 - Madison Station ApartmentsContractor 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 High Country Heating and Air Conditioning LLC Andrew Boyle City Idaho Falls State / Province / Region ID Postal / Zip Code 83401 Country USA Update new contact information that is not already on file with the City of Rexburg Street Address 11187 N Moonbeam Dr. Address Line 2 officehighcountry@gmail.com 208-821-1288 Mechanical (HVAC)012552 5/31/2024 $ Permit Information Please enter in the following format: 00-00000 22-00795 Madison Station Apartments 577 Trejo Acceptance Sign 12/5/2023