HomeMy WebLinkAboutWORK ACCEPTANCE FORM ORANGE ELECTRIC - 19-00447 - 236 N 3rd E - SFR to 4-PlexContractor 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
Orange Electric
Jean-Michel Knickerbocker
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83401
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
587 Reagan Ave
Address Line 2
orangeelectric.knick@gmail.com 208-740-9501
Electrical 024083 1/31/2020 1,700.00$
Permit Information
Please enter in the following format: 00-00000
19-00447 236 N 3rd E - SFR to Duplex
236 N 3rd E
Acceptance
Sign 8/7/2019