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FLA. 1Y67 LAWf ' ~ IIAMCO IORM IlOM 4
F• 71,.09 ~ ~
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(~l~ttm ~a~ ~t~~t ~3Q8~
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~ vf MARTIN
8~for~ m~, th~ undKSi~n~d aulhority. P~rsonall~ appea~~d........DANISL.. W.. TURNT.R.
who, b~in~ duly swom, says that h~ is th~ lienor herein or a~ # oF the lienor herein, .
G. H. WINDOWS,~....INC...,...a Florida Corporation
...........~lienor s Name)
P. O. Box...1682 r.... Stuart , Florida . ...33494.. . - . . . _ . . . :
whose addreu is . ~
(lienor s Address)
and that in purwsr?os of a aontrad with....the..owner.~....BARBOlI~...YSBNQNI
__.......~.?..~.$....~iio... V3~ta...Driqe.,.. Fort. Pierce, . Florida. 33450.. . . .
li~i~or fumishsd labor, services or materials oonsistiny of: (Deuribe speaa~~Y fabricated materisls s~parstefY)
all windows and glass doors used in construction of the
residence on the hereinafter described real estate.
of a taal vslue of...One._.Thousand. One. Hundred._.Seventy.....~~an (s 1~172.69 ~
Two and 69~100--------------°---- ,
~ of which there remains unpa~d S 472...69. for which amoum he daims a lien on the Fdbwing
~ ~ . St. Lucie County, florida: °
. . . .
M-.• . . . .
(pastribe real propsrty wf~iaent~Y Ea ideMification, induding street and number if known)
i Lot 13, Block 11, SURFSIDS UNIT 2, according to the 2~~8
j Plat thereof recorded in Plat Book 11, Page 8, St. ~
~ Lucie County, Florida, public records. f~g thL~
$T. iUCtE GJifMTT F~I~. ~
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pfr-,s- ,r- ~-,cU
M~r ~8 Jl lu PH '1~1 `
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Owned by-......._...BAAR,O~...VF~ON . . .
Hs hxther says that lienor fumishad the first of said (abar, sen?ices or mate~ials on
...October.._3.~..._........_,19..
73 and the last of the same on .-.--.May- Z~ 19_ 7`} and (if the lien
is daimsd by ons nd in privity with the owner) that the lienor served his notice to owner on -
.
. _ .
19-........, y. _ . _ .
(Method of Service)
~ G. H. WI NDOWS I NC.......... ~
. _ . . _ . . ;
Lie
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~--•--..da oF.... ..~Y .......19..'T.4... .
Swom to and subsa~sd b~fore m~ this y
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