HomeMy WebLinkAboutWORK ACCEPTANCE FORM OPTIMUM ELECTRIC - 22-00431 - 277 Jill Dr - Solar PanelsContractor 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
Optimum Electric
Joseph Yorgensen
City
Twin Falls
State / Province / Region
ID
Postal / Zip Code
88301
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
223 Larkspur Dr
Address Line 2
joey@optimum-electric.com 2083294648
Building RCE-60340 11/23/2022 $
Permit Information
Please enter in the following format: 00-00000
22-00431 Daniel Moncayo
277 Jill Drive, Rexburg, ID 83440
Acceptance
Sign 7/1/2022