HomeMy WebLinkAbout19-00729 Contractor Info Form FINE LINE ALARMS LLC.pdfContractor 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
FINE LINE ALARMS LLC
MARTIN PELTON
City
RIGBY
State / Province / Region
ID
Postal / Zip Code
83442
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
4547 E 300 N
Address Line 2
FINELINEALARMS@GMAIL.COM 208-516-0514
Fire Alarm 32412 3/31/2023 $
Permit Information
Please enter in the following format: 00-00000
19-00729 THOMSON FARMS
REXBURG
Acceptance
Sign 6/4/2020