HomeMy WebLinkAboutWORK ACCEPTANCE FORM IDEAL ELECTRIC LLC - 23-00730 - Clubhouse Dental - New Commercial BldgContractor 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
Ideal Electric LLC
Wayne Van Orden
City
BLACKFOOT
State / Province / Region
ID
Postal / Zip Code
83221
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1057w 125s
Address Line 2
jwaynevo@gmail.com 2086814615
2086814615
Electrical ele-c-1029 7/31/2024 95,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00730 Clubhouse Dental
11 Sawtelle Ave
Acceptance
Sign 5/30/2024