HomeMy WebLinkAboutWORK ACCEPTANCE FORM LON RICKS ELECTRICAL - 23-00854 - 5351 W 4000 N - 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
Lon Ricks Electric
Lon Ricks
City
Newdale
State / Province / Region
Idaho
Postal / Zip Code
83436
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Box 27
Address Line 2
415 Church St
lonricks@gmail.com 208-390-1636
Electrical C4926 8/31/2024 $
Permit Information
Please enter in the following format: 00-00000
23-00854 5351 W 4000 N - Shop
5351 W 4000 N
Acceptance
Sign 12/5/2023