HomeMy WebLinkAboutWORK ACCEPTANCE FORM NEPHI'S ELECTRIC - 19-00292 - 53 E Main St - Apartment - 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
Nephs Electric
Nephi Gibson
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
272 N 2000 East
Address Line 2
NEPHISELECTRIC@YAHOO.COM 2083132883
Electrical C-28040 7/20/2020 $
Permit Information
Please enter in the following format: 00-00000
19-00292 Sled shed apartments
53 East Main
Acceptance
Sign 11/15/2019