Form ID

Publication date

Location of premises

Certificate

Building a Detached 2 Storey Dwelling

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
2665111 Ontario Inc. (Eitan Ben-Izhak)
Address of Owner
51 Shallmar Blvd., Toronto, ON M6C 2K2
Name of Contractor
Eitan BenIzhak
Address of Contractor
51 Shallmar Blvd., Toronto, ON M6C 2K2
Name of Certifier
Eitan Ben-Izhak
Address of Certifier
51 Shallmar Blvd., Toronto, ON M6C 2K2

Identification of Premises

Lot 175, Plan 1850, City of Toronto

Office to which claim for lien must be given to preserve lien

c/o Jayson B. Schwarz (attention: Vicky Tan) - 1984 Yonge Street, Toronto, M4S 1Z7 fax # 416-486-3325