HomeMy WebLinkAboutWORK ACCEPTANCE FORM OMNI SECURITY SYSTEMS - 22-00007 - 253 W 2nd S - Sundance Bldg CContractor 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
Omni Security Systems inc.
Mark Pettichord
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
po box 309
Address Line 2
mark.omniss@gmail.com 2087451029
2083902296
Fire Alarm ele-c-15009 2/28/2023 30,800.00$
Permit Information
Please enter in the following format: 00-00000
22-00007 sundance apartments
266 W 3rd S
Acceptance
Sign 3/22/2022