HomeMy WebLinkAboutWORK ACCEPTANCE FORM NEPHI ELECTRIC - 20-00808 - OPTIXS - 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
nephis 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 North 2000 East
Address Line 2
nephiselectric@yahoo.com 2083132883
Electrical c-28040 7/31/2021 17,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00808 legacy
142 w 1st north
Acceptance
Sign 10/14/2020