HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEGACY FIRE PROTECTION - 21-00725 - Iron Horse RV - Interior FinishContractor 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
Legacy Fire Protection
Carlyle
City
Idaho Falls
State / Province / Region
Idaho
Postal / Zip Code
83402
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
234 W 18th St
Address Line 2
chance.carlyle@chfire.us 2087099205
Fire Sprinkler FPSC-166 12/31/2022 86,500.00$
Permit Information
Please enter in the following format: 00-00000
21-00725 Iron Horse RV
1076 S 12 W
Acceptance
Sign 1/5/2022