HomeMy WebLinkAboutWORK ACCEPTANCE FORM PRESTIGE ELECTRIC - 22-00093 - Horizon Power - Commercial 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Prestige Electric, llc
Kevin Forbush
City
SHELLEY
State / Province / Region
ID
Postal / Zip Code
83274
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1580 N 760 E
Address Line 2
prestigeele4u@gmail.com 2082213671
Electrical Ele-c-4978 2/28/2023 950.00$
Permit Information
Please enter in the following format: 00-00000
22-00093 Horizon Power
859 S Yellowstone Highway
Acceptance
Sign 2/28/2022