HomeMy WebLinkAboutWORK ACCEPTANCE FORM INRUSH ELECTRIC LLC - 21-00534 - 772 Nina Dr - 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
Inrush Electric LLC
Nathan Driever
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83401
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
777 Hoopes Ave
Address Line 2
G105
inrushrlectricllc@gmail.com 2082701055
2082701055
Electrical 048391 9/30/2021 $
Permit Information
Please enter in the following format: 00-00000
12-34567 Rexburg
772 Nina Dr, rexburg
Acceptance
Sign 7/22/2021