HomeMy WebLinkAboutWORK ACCEPTANCE FORM NEPHI'S ELECTRIC LLC - 23-00308 - 367 Talon Dr - 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
Nephi's Electric LLC
Nephi Gibson
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
272 N 2000 E
Address Line 2
nephiselectric@yahoo.com 208-313-2883
Electrical ELE-C-28040 7/31/2023 $
Permit Information
Please enter in the following format: 00-00000
23-00308 367 Talon Dr
367 Talon Dr
Acceptance
Sign 5/24/2023