HomeMy WebLinkAboutWORK ACCEPTANCE FORM IDEAL ELECTRIC LLC - 21-00029 - 857 Oak Hill Way - 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
Ideal Electric LLC
wayne van orden
City
Blackfoot
State / Province / Region
ID
Postal / Zip Code
83221
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1057 West 125 South
Address Line 2
jwaynevo@gmail.com 2086814615
2086814615
Electrical ele-c-1029 6/30/2021 6,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00028 vantage point
oak hill drive
Acceptance
Sign 1/20/2021