HomeMy WebLinkAboutWORK ACCEPTANCE FORM VIRGIN ELECTRIC - 20-00151 - 251 Baldwin Dr - Finish BasementContractor 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
Virgin Electric
Jerry Virgin
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
111N. Center
Address Line 2
heinerclan@gmail.com 2083519786
2083519786
Electrical c-777 7/31/2020 2,600.00$
Permit Information
Please enter in the following format: 00-00000
20-00151 Amber and Joel Drake
251 Baldwin Dr.
Acceptance
Sign 3/30/2020