HomeMy WebLinkAboutWORK ACCEPTANCE FORM WIRED ELECTRICAL SERVICES, LLC - 21-00595 - 611 Johnson St - AdditionContractor 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
Wired Electrical Services, LLC
Kenneth Johnson
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
kenjohnson76@me.com 12084204620
Electrical 046912 5/31/2023 100.00$
Permit Information
Please enter in the following format: 00-00000
21-00595 Bedroom addition
611 Johnson Street, Rexburg, ID 83440
Acceptance
Sign 10/14/2022