HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEWIS CORPORATION - 22-00039 - Rexburg Idaho LDS Temple - 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
Lewis Corporation
Kenyan Lewis
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 98,445.00$
Permit Information
Please enter in the following format: 00-00000
22-00039 Rexburg Temple Remodel
750 S 2nd East, Rexburg, Idaho 83440
Acceptance
Sign 4/5/2022