HomeMy WebLinkAboutWORK ACCEPTANCE FORM DALE GARNER ELECTRIC - 21-00180 - Madison Fairgrounds - Announcers Box - ElectricalContractor 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
Dale Garner Electric
Dale Garner
City
idaho falls
State / Province / Region
Idaho
Postal / Zip Code
83441
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
MADISONFAIRGROUNDS@GMAIL.COM 2085897156
208-317-2238
Electrical c3094 3/30/2022 700.00$
Permit Information
Please enter in the following format: 00-00000
21-00180 ANNOUNCER BOOTH
460 W 2 ND NORTH
Acceptance
Sign 3/25/2021