HomeMy WebLinkAboutWORK ACCEPTANCE FORM OKLAND CONSTRUCTION - 21-00208 - Goldenwest Credit Union - Branch OfficeContractor 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
Okland Construction
Brian Leisten
City
Boise
State / Province / Region
Idaho
Postal / Zip Code
83702
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
101 S. Capitol Blvd.
Address Line 2
brian.leisten@okland.com 208-576-6077
208-866-4527
Building RCE-11845 1/24/2022 1,770,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00208 BYU-Idaho Manwaring Center Student Activities
525 S Center Street Rexburg Idaho 83640
Acceptance
Sign 4/26/2021