HomeMy WebLinkAboutWORK ACCEPTANCE FORM CR LIGHTING & ELECTRIC - 19-00102 - 566 E 5th S - Solar PanelsContractor 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
CR Solar
Amy Simms
City
LAYTON
State / Province / Region
UT
Postal / Zip Code
84041
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
380 N KING ST
Address Line 2
amy.simms@crlighting.net 8015106379
Electrical 035239 7/31/2020 25,000.00$
Permit Information
Please enter in the following format: 00-00000
19-00102 Woodwards Solar
566 E 5th S Rexburg, ID 83440
Acceptance
Sign 11/4/2019