HomeMy WebLinkAboutWORK ACCEPTANCE FORM BYU-IDAHO ELECTRIC - 20-00182 - BYUI Long Term Parking ExpansionContractor 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
BYUI Electrical Services
Nathan Cardon
City
REXBURG
State / Province / Region
MADISON
Postal / Zip Code
83460
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
525 south center
Address Line 2
cardonn@byui.edu 2083901781
Electrical ELE-I-10510 12/31/2020 30,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00182 BYUI Parking Expansion
corner on Center st. and Seventh South
Acceptance
Sign 6/15/2020