HomeMy WebLinkAboutWORK ACCEPTANCE FORM NELSON FIRE SYSTEMS - 23-00022 -BYUI Hart - Physical Treatment Center 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Nelson Fire Systems
Kannon Korth
City
Salt Lake City
State / Province / Region
Utah
Postal / Zip Code
84115
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1481 S Major Street
Address Line 2
Office@nelsonfire.com 8014688300
Fire Alarm ELE-C-3858 7/31/2021 10,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00022 BYU-I Hart
306 South 1st West Rexburg, ID 83440
Acceptance
Sign 1/31/2023