HomeMy WebLinkAboutWORK ACCEPTANCE FORM XTREME ELECTRICL INC - 22-00647 - 736 Hillside Dr - 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
Xtreme Electric Inc
BLAKE LARSEN
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Box 177
Address Line 2
XTREME3003@GMAIL.COM 2083133003
2083133003
Electrical ELE-C-27283 10/31/2023 30,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00647 Barber Residence
736 Hillside drive
Acceptance
Sign 4/26/2023