HomeMy WebLinkAboutWORK ACCEPTANCE FORM NOAH"S ARC ELECTRIC - 20-00028 - 430 W 5th S, 101 - Bathroom 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
Noahs Arc Electric
Rhubin Thomas
City
Pocatello
State / Province / Region
Id
Postal / Zip Code
83206
Country
Bannock
Update new contact information that is not already on file with the City of Rexburg
Street Address
P.O. Box 2961
Address Line 2
noahsarcelectric@gmail.com 208-317-3518
Electrical ELE-C-29692 8/31/2020 800.00$
Permit Information
Please enter in the following format: 00-00000
20-00028 Bathroom Remodel
430 W 5th S
Acceptance
Sign 2/11/2020