HomeMy WebLinkAboutWORK ACCEPTANCE FORM D L ELECTRICL LLC - 23-00600 - Cafe Sabor - RemodelContractor 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
D L Electric LLC
David Long
City
Blackfoot
State / Province / Region
Idaho
Postal / Zip Code
83221
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
515 W 27 S
Address Line 2
dlelectric45@gmail.com 2088210101
Electrical 056890 11/30/2024 60,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00600 Cafe Sabor
160 W 2nd S
Acceptance
Sign 1/23/2024