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(Idame of Lier:or)
?~ C31 South u,Ar~et A.venue.t..~~rt Pietas, Florida...--•-• . ...................•----•-•---........_.....
-.. (1'~endence oi- B~a,tirtess tiddress of Eienor}
being duly sworn says that in pursuance of a torttracct with ..._.-~lair~..~titahi??~!~~' ~`"i ~tillia~ J.
Ccndy; dba G & G Auildin~ S~eoia~lties ~ 6~~li~ncee, 3210 Orange Ave., Fort i'ierce
(Name of Lienor's Employer or p~er.;or. with reihorn he ce.~ntracted}
labor a~ad
he ~ pe~~~rrned 1 the following ~ ~ (Here describe the labor or sercilces performed or
f urn~shed j materials
materials furnished. Describes eeta.l abricated muteria~. se aratel ~ . -.. ------.,--- -----------•-
p' t y f s p y?--------•--- --
]h~t:t+~or~ lass.-grilles and ~lenu~ ....................... :~~g3+~
-------• ....................................... ~~• r'1~~~--P~F~'~1~~ED....-------..
16~ 3j.: OD ~efri~erant. Coi~®r---------••-----------------~~-~u~---------
---....'.2~ -? •'8 OD Refri rant Ccpper_....._
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10~ 3/4 ID A.r~flea ........ .............................~ - `u 1' 1~•-_;..-_..1.:»....
....--/ .................................... -.. ~ ~ -~ t ~t.
T.a1-:nr fnr the forestair_a inst_~Ilation -.~~__E COJIi'?1`, Fli!i, ~
to tht value nt-------~'-~'--~.u~rrd..Fnr-t3--.fain-~_dSf.J.DD..-(.33~a4~db 3.411x.ra------------ ................
(State contract price)
on the ,rollowing described real property. (Describe real property su$iciently for identi fication, giv-
ing street and number if knouJrtj :...._L~'C--~'-~ss...~.xr;rlr~;..-.Sa:r!'situ..~ni.t..,J.~ ........................
-art tierce, rlorida
O?.Lried by. ~ .................................
c-'J''i -- -•-------------------••- ..........-...-----
--.-....Y.l .. x...
(Name o f ow~?er ugair?st iuhosc interest lien is chimed )
wtu~se interest in uch reai pro pert+; is.---- ---- - .................................._-....---------...--------,-- ------------------
(itate owner's interest; as fee sirrtpl2, life, estate, lease-hold, i f known 1
labor asd (
. pzrfor ned sever t;~-------•
fie further says that the last :tern of u'as{ fi~E,iz on the.-.-._'----------- --
i1ta~FrYalS l
da o 't~_,.~,~st , ly~~...., ar:d, of the contract price stated, there is u~lhaicj.., ,•
a ^,.~ (.'
the (?1,:C~4Liit 1Jf. o - .1i~?a-r~ ..... ..........::Z~..... ~...Y;'',~,~,....... ~Y:i.afr:?.. A~:ri<~:~~. i _ -
(State arne?:rtt u~r~pE<iEl i
fclr il.'~?ii h a,11E?ilrit f<?e' Cre?~>t5 U l;e'n ;ifi tfiL' .•eal rhYOpelty nerC'tn !tE'SCTYbC~. ~ •` -
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