HomeMy WebLinkAboutWORK ACCEPTANCE FORM TETON ELECTRIC & PLUMBING - 22-00014 - 1065 Cypress Loop - New SFRContractor 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
Teton Electric & Plumbing
Jared Vincent
City
Pot
State / Province / Region
Idaho
Postal / Zip Code
83201
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
6489 W Pocatello creek rd
Address Line 2
tetonelectric@gmail.com 2082418115
Electrical Ele-c-39032 9/30/2022 35,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00014 1065 cypress-new sfr
1065 cypress loop
Acceptance
Sign 8/26/2022