HomeMy WebLinkAboutWORK ACCEPTANCE FORM HOTWIRE ELECTRIC - 21-00254 - 1279 Stone Dr - Basement FinishContractor 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
Hotwire Electric
Blaise Kauer
City
Ammon
State / Province / Region
ID.
Postal / Zip Code
83406
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
3270 East 17th #234
Address Line 2
hotwireelectricllc@gmail.com 2086041871
Electrical ELE-C-34487 12/31/2022 4,800.00$
Permit Information
Please enter in the following format: 00-00000
21-00254 Bryan Waldron
3270 East 17th #234
Acceptance
Sign 2/27/2022