HomeMy WebLinkAboutWORK ACCEPTANCE FORM RONN ALLEN ELECTRIC - 21-00834 - 279 N 2nd E - Car Wash OfficeContractor 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Ronn Allen Electric
Michael L. Jensen
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83402
Country
Bonn.
Update new contact information that is not already on file with the City of Rexburg
Street Address
505 west 20th street
Address Line 2
mike.raelectric@yahoo.com 208-520-9421
208-520-9421
Electrical c-3118 5/31/2022 5,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00834 Rays car wash
279 N 2nd E
Acceptance
Sign 10/26/2021