HomeMy WebLinkAboutWORK ACCEPTANCE FORM ELK RIDGE ELECTRIC - 21-00313 - 320 S 4th E - 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
Elk Ridge Electric
Gary Goodnough
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
elkridgeelectric@gmail.com 208-360-7502
Electrical 017404 11/30/2021 15,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00313 Remodel
320 S 3-4th E
Acceptance
Sign 6/7/2021