HomeMy WebLinkAboutWORK ACCEPTANCE FORM OMNI SECURITY SYSTEM - 20-00393 - Crapo Apartment - Duplex to 4-Plex 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 acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
omni security systems inc
mark pettichord
City
rigby
State / Province / Region
idaho
Postal / Zip Code
83442
Country
usa
Update new contact information that is not already on file with the City of Rexburg
Street Address
po box 309 3905 e 200 n
Address Line 2
mark.omniss@gmail.com 2087451020
Fire Alarm rce-1278 1/1/2021 5,400.00$
Permit Information
Please enter in the following format: 00-00000
20-00393 crapo apartments
150 E 2nd S, Rexburg, ID 83440
Acceptance
Sign 10/28/2020