HomeMy WebLinkAboutWORK ACCEPTANCE FORM IDEAL ELECTRIC - 18-00552 - 532 Woodbridge St - SFRContractor 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 acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
Ideal Electric
Wayne Van Orden
City
Blackfoot
State / Province / Region
ID
Postal / Zip Code
83221
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1057 West 125 South
Address Line 2
jwaynevo@gmail.com 2086814615
12086814615
Electrical Ele-c-1029 6/30/2019 5,000.00$
Permit Information
Please enter in the following format: 00-00000
18-00552 fall creek woodbridge
532 woodbridge st
Acceptance
Sign 5/9/2019