HomeMy WebLinkAboutWORK ACCEPTANCE FORM ELECTRIC CONSTRUCTION & SALES - 21-00435 - Twin Pines Manor - 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
Electric Construction & Sales, LLC
Pam Hill
City
Pocatello
State / Province / Region
ID
Postal / Zip Code
83205-4054
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Box 4054
Address Line 2
ecsoffice19@gmail.com 12082349999
Electrical 029237 2/28/2022 34,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00435 Twin Pines Manor
160 N. 1st W.
Acceptance
Sign 8/26/2021