HomeMy WebLinkAboutWORK ACCEPTANCE FORM PHOENIX FIRE PROTECTION - 17-00679 - 430 W 2nd S - Providence Square - Bldg #13Contractor 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
Phoenix Fire Protection
Teri Cruickshank
City
Nampa
State / Province / Region
ID
Postal / Zip Code
83687
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
4130 Airport Rd.
Address Line 2
teri@phoenixfp.com 208-468-9115
Fire Sprinkler 108 12/31/2019 468,327.00$
Permit Information
Please enter in the following format: 00-00000
17-00679 Providence Square
430 W 2nd S
Acceptance
Sign 11/5/2019