HomeMy WebLinkAboutWORK ACCEPTANCE FORM ELKRIDGE ELECTRIC - 20-00950 - Stone's Car Wash - 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
Elkridge Electric
Gary Goodnough
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
elkridgeelectric@gmail.com 208-360-7502
Electrical 017404 11/30/2021 7,500.00$
Permit Information
Please enter in the following format: 00-00000
20-00950 Stone's Car Wash - Remodel
615 S Yellowstone Hwy
Acceptance
Sign 12/29/2020