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. 45.9631 ' L\
~q~ IIAMCO F011M 11014
uE« u?w. n ~aa ~
~ c St. Lucie j
~ )11
Before rr1e. the undersigned authority. P«~h?appeared......RObe~rt..8....F.ren,ch
who. being duly sworn. says that he b the lienor herein a tM pent of tM lierar herein
.....South„Florida,.Air. Conditioninc~~...Inc.
- (LNnor's Name)
addn>ss 109„ N.,,, 29th„ St.,, Ft.,,,Pierce,,, Florida 33450,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
hienor's Address) ~ .
and that in purswnw of a contract with.......1~Q~}~t...r~QK~..Builders...~I;iC,! .
..~07it..~~~..,&X11.,...~?.iR~~.~fl -
lienor famished labor, serviws or materiak conslstirlp of: )Describe specially fabricated materiab separately)
Carrier Air Conditioning Equipment
Duct Work
Condensate Piping
Copper Refrigerant Piping -
Grills
on the folbwinp described nal property in ......s$,t,,,,,Luce„ COUnty
.....................................County. Florida:
iDsscribe reN property spifidendy for identification, indudirp street and rwmber, if known)
1125 S.S. Cambridge Drive Port St. Lucie
Lot 25 Block 52 -Tract U-5
owned by ~ ~ ~ i;l~.. z ~ l$...5..~+..... ~.ax~~ SS~.A...S.~.....,&tu~xt
W 11 am
of a total value of .One.. thousand two hundred fifty..,,,,-.,-..dollars (s ,1250-.00,,,,,,,,,,,,,,,,,,,)
of which there remains unpaid =..625,.00 ~ ...-„---,for which amount M claims a lien on the above
described real property.
' He further says that lienor famished the first of said labor. services or materials on July --2 r
78..x.9.., and the Iast of the same on.-,~l~lly....2... 18.9.., and (if the lion - - -
is claimed by one not in privity with the owner) that the lienor served his notice to owner on
:.........................................18........... lyy............................................................................................................... .
(Method of Service)
and, lit the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
owner on
o ' (Contractor)
on .18........... by...................................................................---..... ,
(Method of Service)
and additionally, (if the lien is chimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on
(Subcontractor)
459631
on ..........:...,hey,---......................-----................... 7s.........., by...........................................---.......-----................. .
«~..~~~~•u~~,,,, L- _ (Method of Service ~ •
. , 1919 SEP 19 A!! I~ 50.
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:Q ~ L AliO RECOf~DEO Lienor ~
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` ' ~'~0~1` i~ ~ S~ROGEftP017RA3A~
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L-~'•~.fi. ~ ~ ~ ~ fif:C01t01'ERlFtE4_,C~~~if.~t,~ A
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.
'%,~jdl~%~~ubscribed before m• this.. 13th dey of Septetaber: ........................199.....
. Q~.~CL:~/
C~1~~ Notary Public
Phis Inslrurn~•nf prr/x~rr~d 6~•: .
;td~lrrss p~ ~ Colaolitsioa Expice= Jtlt)? 1,19$3
Bat `t P~E~