HomeMy WebLinkAboutWORK ACCEPTANCE FORM DESIGN TEAM - 21-00250 - BYUI Manwaring Center Activities & Involvement - 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
DesignTeam
Ana Carone
City
Salt Lake City
State / Province / Region
UT
Postal / Zip Code
84106
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
3050 South 900 East
Address Line 2
ana@designteamslc.com 8014939000
Building 3754695501 11/30/2021 17,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00250 BYU-I Activities Center Remodel
101 E Viking St. Drive, Rexburg, ID, 83460
Acceptance
Sign 6/21/2021