HomeMy WebLinkAboutWORK ACCEPTANCE FORM ELECTRIC CONSTRUCTION & SALES LLC - 22-00636 - Temple View Care Center - Shower 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
Electric Construction & Sales,LLC
Electric Construction and Sales, LLC
City
Pocatello
State / Province / Region
ID
Postal / Zip Code
83201-6644
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
856 S 2nd Ave
Address Line 2
Suite A
ecsoffice19@gmail.com 2082349999
Electrical 029237 2/24/2024 4,500.00$
Permit Information
Please enter in the following format: 00-00000
22-00636 Templeview Care Center Shower remoddel
660 S. 2nd W
Acceptance
Sign 2/12/2024