HomeMy WebLinkAboutWORK ACCEPTANCE FORM BLUNCK ELECTRIC LLC - 23-00585 - CL Storage - Bldg 1 - Shell OnlyContractor 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
Blunck Electric LLC
Pete Blunck
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
blunckelectric@gmail.com (208)709-5687
Electrical ELE-C-1914 2/28/2025 46,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00585 CL Storage - Bldg 1 - Shell Only
4721 S 2860 W
Acceptance
Sign 4/22/2024