HomeMy WebLinkAboutWORK ACCEPTANCE FORM GRIZZLY GROUP LLC - 23-00924 - 1110 Castle Pines Rd - 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
Grizzly Group LLC
Quinten Bair
City
Rigby
State / Province / Region
ID
Postal / Zip Code
834;2
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
142 N 4400 E
Address Line 2
grizzlyelectric@live.com 2085209767
2085205225
Electrical Ele-c-31836 1/31/2024 8,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00924 1110 Castle Pines Road
1110 Castle Pines Road
Acceptance
Sign 12/14/2023