HomeMy WebLinkAboutWORK ACCEPTANCE FORM BYUI ELECTRICAL - 19-00632 - BYUI Student Health Center - 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 acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
BYU-I
Steve Price
City
Rexburg
State / Province / Region
Idaho
Postal / Zip Code
83440
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
525 South Center
Address Line 2
5614 West 6000 North
prices@byui.edu 208 496 2540
208 313 4655
Electrical ELE-I-10510 12/31/2019 1,015.00$
Permit Information
Please enter in the following format: 00-00000
19-00632 Student Health Center
Student Health Center Building
Acceptance
Sign 10/31/2019