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HomeMy WebLinkAboutWORK ACCEPTANCE FORM 3-D FIRE PROTECTION - 19-00727 - Spori Annex - Ceramic & Sculpture LabsContractor 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 Delta Fire Systems, Inc. dba 3-D Fire Protection Kelly Bateman City Idaho Falls State / Province / Region Idaho Postal / Zip Code 83401 Country United States Update new contact information that is not already on file with the City of Rexburg Street Address 6312 S. Burggraf Way Address Line 2 kelly.bateman@3dfire.us 2085258377 Fire Sprinkler FPSC-008 12/31/2020 60,431.00$ Permit Information Please enter in the following format: 00-00000 19-00727 BYU-I Spori Annex Ceramics Lab 525 S. Center Street Acceptance Sign 3/5/2020