HomeMy WebLinkAboutWORK ACCEPTANCE FORM S&S ELECTRIC - 22-00827 - 175 Valley River Dr - McDonalds - 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
S&S electric
Derik Sutton
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
dsutton@sandselec.com 2083907877
Electrical 023524 7/21/2023 11,600.00$
Permit Information
Please enter in the following format: 00-00000
22-00827 McDonald’s
175 valley river drive
Acceptance
Sign 11/28/2022