HomeMy WebLinkAboutWORK ACCEPTANCE FORM BRIGGS ELECTRIC - 21-00488 - Denny's - New Commercial BldgContractor 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
Briggs Electric
Michael Briggs
City
Burley
State / Province / Region
Idaho
Postal / Zip Code
83318
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
346 East 300 South
Address Line 2
mbriggs1979@gmail.com 2083122667
2083122667
Electrical ELE-C-25536 9/30/2023 100,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00488 Denneys
585 North 2nd East Rexburg Idaho 83404
Acceptance
Sign 4/24/2023