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.4.16163
FLA. 1Y67 LAWf RAMGO FORM tapM
Ff 71,.0e
~l~xim ~t~en
Glenn K, Boyd
BeFon me, the undersigned authority, personally appeared........._
who, being duly sworn, says that he is the lienor herein or the agent of the lienor herein,
the attorney
Gold Coast Lighting
(Lienor's Name)
I004 South ~J.S.I FT.Pierce ,Florida
whose address is _ _ ,
(4enor's Address)
Treasure Coast 81ds.
and that in pursuance of a contrail with - . ,
29I Port St.Lucie BLvd.n Port Saint Lucie
(ienor furnished labor, services a materials consisting of: (Describe specially fabricated materials separately)
Lighting Fixtures
!r~edicine Chest
of a total value of...E.i9ht_ hundred forty three dr 42~10~ollars (s 943.42 )
of which there remains unpaid s ~ 4 3 .4 2 ,for which amount he daims a lien on the fdlowirg
described real property in - Saint ..Lucie. County, Florida:
(Describe real property wfficiently fc. identiFication, including street and number iF known _
. ~ .
Lot 28 glk 7P7 4:361b3
Port S*_. Lucie Section I9 '7~ 5 P(l~ 3 27
~ -
I - _ _
Treasure Coast guilders ~ Richard FlanzbauR) Presider,
Owned by _ . _ _ _ _
I
Ffs further says that lienor furnished the first of said labor, services or materials on J a n u a t y 17
19.. ~.g, and the last of the same on ..February ~ ~ 19 ? 9, and (if the lien
is chimed by one not in privity with the owner) that the lienor served his notice to owner on
ti
_~....~...~~....C t97.~, by
(Method of Service)
s
Gold i.o2St .Lightingr .Inc.
= Tenor
Age or Attor }
,
Sworn to and subscribed before me this-_._ ~ . ......day of ll-:'ZGw _..19
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Notary Public - `=4~'
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Notary PuDlk. state of Flo?Ma At urge
/7u~ /itvrti~ur?il /err/~~~n~l l~1'- MY Comrr~sion Expkes Nov. 2~, 198p '
l Bco4M B~ R.f1.•. ~n,ugwce C0.
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