HomeMy WebLinkAboutWORK ACCEPTANCE FORM HOTWIRE ELECTRIC - 20-00886 - 859 Pine Brook - Faires - New SFRContractor 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
Hotwire Electric
Blaise Kauer
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
hotwireelectricllc@gmail.com 208-604-1871
Electrical ele-c-34487 12/31/2020 12,500.00$
Permit Information
Please enter in the following format: 00-00000
20-00886 Faires
853 Pine Brook
Acceptance
Sign 11/13/2020