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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