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FIA. 1N7 lAW! ~a~ eAMCO fO11M 1=O~t
F! ~ 1'.00
~l.~u~t ~f ~t~~t
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~ of St. Lucie
defon nle, thr und~rsi~led authority, personally aPP+grad-.... L A....O.'.Laugh13n., Jr .
. - t1ti~Y~ii>X
who, benl~ duty sworn, says thN he is the I'iellor herein a ~ dle attorney # of the lienor herein,-
JACOBS AIR CONDITIONING, INC.
831 Edwards Road (P.O.Box 1232) Fort Pierce, Florida 33450
whose address i:................_._..........__-----------------------_.......... - - - .
(tienor's Address) - -
and that in pursllanoe of a oorllrad with-...Charles Gilsinan
lierlor flrrlislled lsbor, servioes a materiak ao~sfin~ of: (Descn~e specially fabricated materiak separately)
Installation of Central heat and air conditioning and ductwork
and 32/100
of a total value of. Two..thousand nine. hundred eghty.-.one.- ~s 2981-.32 . )
of which there remains unpaid : -1 ~ 7 50.00 _ _ _ _ for which allwullf hs dailrls a lien on the foNowins
dssal~ed real property in- - ---St-' . _ _ .County. Florida:
(Describe real property suHidedlt? for identification, irldudNl~ streM and number if known)
726 S. E. Essex Drive, Port St. Lucie, Florida 33452
Lot 4 Block 790 Port St. Lucie Section 18 1=tLED AND RECORD~d~-
. t'JCIE COUNTY. FLA:`
• ~~:."O~r VERSF~E43
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Charles G~Ls~azt a~s~_.Fiq~nce..Gil;;i~an......_CL~-~~`.-~I~CC~' c;;L'RY
Owned by.....--•----------- ~ ~ - - - -
He further sags that fiercer filrrlislied the fast of said labor, services or materiak on.........._ .
August 21 x.78 arld ~ ~ of the same on NO..?!ember .24 ~ 78~ and (if the lien
_ .
is dainisd by one not in privity wish the owner) that the kenos served his rloticd to owner on
. ~ . Method of Service
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~ - µr , r - ~ Y~ j; ` J COBS R CONDIT ON IN .
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~ or '''~r~,,.~'£ L. A. 0'La
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' sworn to and subsal~.d before m. this ...............l~P....._.........:_.............dar of...._............. .19 -
Notary fiubfic
/ j, , L.A. O'Laughlin Jr tVotary Public. State Flonda at large
17ru I,cclmirnr~ pir-prmri y' ~ My Comm~ssian Expues Jan. 8, t~
A~Irlaxs O'Laughlin & O'Laughlin -
P.O. Box 3405
~ Fort Pierce, Florida 33450 ~~K~~ ~e~~.
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