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FIA. 1967 LAWS ; 11AMC0 FORM ttpq
FS 713.Od
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Befors ms, the undersiqned authority, pe?sonalty appearsd.. .THOMA$ R. SHAHADY
who, bein9 duly sworn, says that he is the lienor he?ein or ~ ~h~~~~~~y # of the lienor herein,
ADOBE BUILDING CENTERS, INC., f/k/a ADOBE BRICK AND SUPPLY CO.
. . _ . . .
(Lierwr's Name)
353 Florida Avenue, Ft. Pierce, Florida 33450 ~
, whose addreu is . . .
_ _ _ _ . .
(Lienor s Address) ~
and that in purwanos oF a contrad with SIGMA ..SERVICES CORP. , INC.
. . . . . .
.
,
. _ _ . . _ ,
lienor Fumished labor, serv+oes or materials consisting of: (Describe specially fabricated materials separately)
Drywall materials and
other related items
SEVEN THOUSAND, FIVE HUNDRED, ~
of a total value oF.- F.pi,IRTEEN. . and 19/100 dolla:s (S 514 .19
)
oi which there remains unpaid S._- 514 .19 , ~ar which amount he claims a lien on the following
describad real r ~n.. St. Lu~cie
P ~~Y ~ . _ _ . _ _ County, Florida:
(Describe real property suFfiaently for idenlification, induding street and number if known)
See legal description attached hereto
and made a part hereof '
~
KENNETH I. VanCOTT '
~ owned by . _ _ . _ _ . . . . _ . . . . :
; Hs Fu~ther says that lienor fumished the first of said labor, services or materia(s on . _ i
! - ~
~ .July...b ~9.~-3., and the last of the same on .......September 1$ 73 =
. , 19 _ , and (ii the lien ;
is daimed by one not in privity with !he owner) that the lienor served his notice to owner on .
;
; ~uly,...12 19.?-3., by. . _ _ Certified Mail
~ _ _
s (Method oF Service)
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ADOBE BUILDING CENTERS, INC., f/k a '
~ ADOBE .BRICK Al~e~jJPPLY Cb. ~
:
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A~qe~f or Attomey ~ R
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` Swom to and subscribed bsfore me ihis.~,,,........,.~:`?..t.` ..................day of October ~q 73 '
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' % lri.~ Ilrslr~~nir~il ~rr ?~rrrd ~ . ~ C . NOTJIRT PUBtIC, ST111'E oi RDRiDA at URG'E
; f f ~ M1?cu;.i:A15..:.NEX?'GiE3~UN. 24, i97~
! 4'. ` sOMDED TMROUGH FRED W. OI~STEtHpQgj
e .~~i~i~rr« THOMA3 R. ~~~i~hisiVi' t.j
' 2iSti :1C0" SiRFET O R A~A
s HOL~I:+JOD. FLA. 33020 *r J?~~~i ,r
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