HomeMy WebLinkAboutWORK ACCEPTANCE FORM ORANGE ELECTRIC LLC - 20-00170 - 310 S 5th W - 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
Orange Electric LLC
Jean-Michel Knickerbocker
City
IDAHO FALLS
State / Province / Region
ID
Postal / Zip Code
83401
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
587 REAGAN AVE
Address Line 2
Orangeelectric.knick@gmail.com 2087409501
Electrical 024083 1/31/2020 8,000.00$
Electrical N/A 3/25/2020 8.00$
Permit Information
Please enter in the following format: 00-00000
20-00170 310 s 5th w remodel
310 s 5th w Rexburg, Idaho 83660
Acceptance
Sign 3/31/2020