HomeMy WebLinkAboutWORK ACCEPTANCE FORM RIVERS EDGE ELECTRIC - 21-00022 - 637 Autumn Ct - Addition/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
Rivers Edge Electric
Quinn Christensen
City
Rigby
State / Province / Region
Idaho
Postal / Zip Code
83442
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
97 N Cambridge Dr.
Address Line 2
rivers.edge.elec@gmail.com 208-716-9328
Electrical 039577 2/28/2021 3,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00022 Additon-Remodel
637 Autumn Court Rexburg, ID 83440
Acceptance
Sign 1/13/2021