HomeMy WebLinkAboutWORK ACCEPTANCE FORM ELITE ELECTRICAL SERVICES - 23-00195 - 2738 W 4000 N - New SFR Mechanical & ElectricalContractor 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
Elite Electrical Services
Tanner Anderson
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
eeservices4@gmail.com 2086707002
Electrical 060750 8/31/2023 $
Permit Information
Please enter in the following format: 00-00000
22-00161 Tyler Thueson
2738 W 4000 N Rexburg ID 83440
Acceptance
Sign 5/22/2023