HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEGACY ELECTRIC - 22-00588 - Cedar Point Trucking - 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
Legacy Electric
Ryan Leishman
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
ryanleishman@msn.com 208-390-3306
Electrical 35219 6/30/2023 180,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00588 Cedar Point Trucking
3202 W 5000 S
Acceptance
Sign 5/19/2023