HomeMy WebLinkAboutWORK ACCEPTANCE FORM TIMBER CREEK ELECTRIC - 19-00396 - 157 N 2nd E - Tenant RemodelContractor 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
Timber Creek Electric LLC
Casey Nielsen
City
Pocatello
State / Province / Region
ID
Postal / Zip Code
83201
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2072 Beth St.
Address Line 2
timbercreekelectric@gmail.com 208-716-2186
Electrical 026893 6/30/2020 $
Permit Information
Please enter in the following format: 00-00000
19-00396 157 N 2nd E - Tenant Remodel
157 N 2nd E
Acceptance
Sign 8/20/2019