HomeMy WebLinkAboutWORK ACCEPTANCE FORM PREMIER ENERGY CONTROLS - 21-00214 - Precision Chiropractic - 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
Premier Energy Controls
Ronnie Schaeffer
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
154 n 3974 e
Address Line 2
rschaeffer@premiercnt.com 208-380-9303
Electrical 008844 3/31/2023 850.00$
Permit Information
Please enter in the following format: 00-00000
21-00214 Precicion Chiropratic
305 W Main St. Rexburg ID
Acceptance
Sign 4/7/2021