HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEWIS CORPORATION -21-00471 - BYUI Romney Building - 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
Lewis Corporation
Heidi Pope
City
Pocatello, Idaho 83202
State / Province / Region
ID
Postal / Zip Code
83202
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
15136 W Hunziker Road
Address Line 2
heidi@lcorp.com 2082381202
Mechanical (HVAC)HVC-C4440 5/31/2022 59,483.00$
Permit Information
Please enter in the following format: 00-00000
00-00000 BYU-I Romney VAV upgrade 2021
525 S Center Street, Rexburg Idaho
Acceptance
Sign 5/6/2021