WINDOWSDate j, // 7 // g Job Address
Legal Description n
Owne / Tenant • ) it/ i 1/ a- � C . Pe rr-`7
Owner's Address
Contracting Co. 1//$4 �/ " c o DiBea-r s f -CA Address
Qualifier r n 9 d-4.4 ON. SS#
/ Phone 3' -9 2 1 / )( c
Ins. Co.
Date
Notary as to Contractor • Owner- Builder
My Commission Expires:
4 sAY P4 m Martin Lipton
2� u► Commission # CC 734744=
.; � ,s Expires May 3Qf 2 "'v
9 woF F1� ATIIWT(G°�tit1NDING O , I NC:
6/748"
Date
BOND
oa
TOTAL DUEL '
Engineering
COMPLETE PERMIT SERVICE
KATHLEEN C-O- R CHIAN1
ZONING= CONSULTANT .-
TEL. (305) -0013
- PAGER (305) 413-3B18