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HomeMy WebLinkAboutWORK ACCEPTANC FORM LEGACY ELECTRIC - 23-00874 - 893 Oak Hill Way - 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 Legacy electric Nick leishman City Rexburg State / Province / Region Idaho Postal / Zip Code 83440 Country Update new contact information that is not already on file with the City of Rexburg Street Address 4455 Jud st Address Line 2 nickleishman@gmail.com 2087160420 Electrical 35219 6/10/2028 23,000.00$ Permit Information Please enter in the following format: 00-00000 23-00874 Bridger jacobs Pine brook estates Acceptance Sign 1/29/2024