Fill and Sign the Notice of Completion Utah State Construction Registry Form

Notice of Completion - Utah State Construction Registry 30 E. Broadway Suite 300 Salt Lake City, UT 84111 (801) 983-0275 or (877) 9UT-EGOV FAX: (800) 585-1534 SCR User Name or Account #       This Notice is fiee or State Construction Registry Project #: Note: A vaiie SCR Project #, Buiieing Permit #, or Project ID # is requiree      Project Information Buiieing Permit # or Project ID: Buiieing Permit/Project ID Not Appiicabie Issuing Municipaiity: Not Appiicabie Project Aeeress:                   Originai Contractor Name/DBA Name:                   Project Type: Commerciai Resieentiai Originai Contractor Teiephone:       Speci y how eiigibiiity or fnai compietion was eeterminee: Permanent Certificate of Occupancy was issued by the local government entity having jurisdiction over the construction project. Final Inspection of the construction project complete – no Certificate of Occupancy required. Determination that no substantial work remains to be completed – Neither a Certificate of Occupancy nor Final Inspection is required. Filer Information Fiier Type: Owner o construction project Originai contractor Surety Leneer Fiier Name ane Aeeress:                   Same as iistee uneer SCR Account ID Specifee Above Fiier Teiephone:       Fax:       Emaii:       Payment Processing Fee $15.00 Check Enciosee – Check #       (make checks payabie to Utah Interactive) Biii my Visa Mastercare Care #       Expiration Date:       /       I have an account on fie with the SCR – piease biii me. NOTE: I you eo not have a creeit account with the State Construction Registry program, you must inciuee payment o check or creeit care. Faiiure to proviee payment wiii resuit in this notice being returnee as not filed. NOTICE: Terms and Conditions – Processing fees are due at the time of filing. Aii ees are associatee with the State Construction RegistryFees are non-re uneabie. Fiiings wiii be eeemee “fieed when the eesignatee agent receives a compiete orm ane vaiie payment. Incompiete fiings wiii be returnee as not fiee ane corrections wiii be subject to an aeeitionai processing ee. The ineivieuai or entity fiing this orm assumes aii iiabiiity or the compieteness ane accuracy o the orm, ane or it being “fieed within the time iimits specifee in Utah state iaw. Neither the state o Utah, the SCR, nor its eesignatee agent is responsibie or iost, iate, or miseirectee maii. The state o Utah, the SCR, ane its eesignatee agent specifcaiiy eisciaim any iiabiiity or the timeiiness ane accuracy o any fiings, inciueing aiternate fiings submittee accoreing to ofine methoes ( or exampie, but not iimitee to, teie ax ane maii submissions). Signature: Titie:       Date: