HomeMy WebLinkAboutWORK ACCEPTANCE FORM NEPHI ELECTRIC - 19-00577 - 107 & 119 N 1st E - Ollie Manor - New MFRContractor 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
nephis electric
Nephi Gibson
City
REXBURG
State / Province / Region
ID
Postal / Zip Code
83440
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
272 North 2000 East
Address Line 2
nephiselectric@yahoo.com 2083132883
Electrical c-28040 7/31/2020 $
Permit Information
Please enter in the following format: 00-00000
19-00577 Andrea Hepworth 8-Plex
not sure
Acceptance
Sign 5/12/2020