HomeMy WebLinkAboutWORK ACCEPTANCE FORM SYNERGY ELECTRIC SOLUTIONS - 21-00230 - 934 W 7th S - AdditionContractor 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
SYNERGY ELECTRIC SOLUTIONS, INC.
AMY JONES
City
RIGBY
State / Province / Region
ID
Postal / Zip Code
83442
Country
UNITED STATES
Update new contact information that is not already on file with the City of Rexburg
Street Address
3943 E 200 N
Address Line 2
AMYJ@SESID.US 208.228.5535
208.390.0885
Electrical 018980 6/30/2021 $
Permit Information
Please enter in the following format: 00-00000
21-00230 TYLER MARTIN ADD ON
934 W 7TH S
Acceptance
Sign 4/16/2021