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HomeMy WebLinkAboutWORK ACCEPTANCE FORM B H INC - 19-00764 - 117 N 2nd E - Verizon Wireless - Cell TowerContractor 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 BH INC Josh Woodbeck City Vernal State / Province / Region UT Postal / Zip Code 84078 Country US Update new contact information that is not already on file with the City of Rexburg Street Address 826 S 1500 E Address Line 2 jwoodbeck@bhico.com 435-789-5252 435-503-7007 Building RCE-49617 11/15/2020 23,832.00$ Permit Information Please enter in the following format: 00-00000 19-00764 ID6 Rexcamp 117 North 2nd East Rexburg, ID 83440 Acceptance Sign 1/16/2020