HomeMy WebLinkAboutWORK ACCEPTANCE FORM S&S ELECTRIC LLC - 19-00599 - 72 S 1st E - Grand Peaks Medical - 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
S&S electric
Derik Sutton
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
dsutton@sandselec.com 2083907877
Electrical 023524 7/31/2020 81,000.00$
Permit Information
Please enter in the following format: 00-00000
19-00599 Grand peaks rexburg
72 S 1st street
Acceptance
Sign 11/5/2019