HomeMy WebLinkAboutWORK ACCEPTANCE FORM GL EDWARDS ELECTRIC - 20-00637 - Dance Studio - 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
GL Edwards Electric
LeRoy Edwards
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
gledwardselectric@gmail.com 208-403-9614
Electrical 27774 3/31/2021 6,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00637 Dance Studio - Remodel
121 E Main St
Acceptance
Sign 8/17/2020