HomeMy WebLinkAboutWORK ACCEPTANCE FORM OMNI SECURITY SYSTEMS INC - 23-00037 - Rexburg Pediactrics - 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
OMNI SECURITY SYSETMS INC
MARK PETTICHORD
City
RIGBY
State / Province / Region
ID
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
Address Line 2
MARK.OMNISS@GMAIL.COM 2087451020
2083902296
Fire Alarm rce 1278 1/4/2024 8,500.00$
Permit Information
Please enter in the following format: 00-00000
23-00037 REXBURG PEDIATRIC REMODEL
404 N 2 ND E REXBURD ID 83440
Acceptance
Sign 2/14/2023