HomeMy WebLinkAboutWORK ACCEPTANCE FORM BLANE ROBBINS ELECTRIC - 21-00766 - Yellowstone Heights Condos - Bldg 1 - 12 PlexContractor 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
Blane Robbins Electric, Inc.
Travis Robbins
City
Blackfoot
State / Province / Region
ID
Postal / Zip Code
83221
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
431 W 100 N
Address Line 2
sbsrobbins@aol.com 208-785-4674
208-709-6344
Electrical ELE-C-12881 12/31/2022 $
Permit Information
Please enter in the following format: 00-00000
21-00766 Yellowstone Heights
238 Ella Ln
Acceptance
Sign 2/22/2022