HomeMy WebLinkAboutWORK ACCEPTANCE FORM S & S ELECTRIC - 23-00748 - Starbucks - Electrical for Shell onlyContractor 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
Ririe
State / Province / Region
Idaho
Postal / Zip Code
83443
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Po Box 433
Address Line 2
dsutton@sandselec.com 2083907877
Electrical 023524 7/31/2024 104,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00396 Starbucks
1050 Golden Beauty Dr, Rexburg, ID 83440
Acceptance
Sign 10/11/2023