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ru?. tftt MECwutat- ~ RAMCO FOAM 12OV?
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8efore me, tM undwsipned authority, persortatty appaamd Robert F. French
who. being duly serorn, gays that ite is the lienor hamin or tM apsnt of the lienor heroin,
..South Florida Air Conditio~inc~,: Ft. Pierce, Inc.
- ~ (LierlOr•s Name)
tetto~a~~;s.1098. NQ•..29-th,• Street Ft, Pierce, Florida 33450.
luerar's Addmssl
and that in rsw Fr De O .
pu rtceofacontractwith...........,.,...'~1,,,t~a~..~on$ttu~tiQ}~..C4?nP~}1Y
- 3?1 Midway Road, Ft. Pierce, Flo~cida 33450
benor furnished 4bor, senriws or ttutarials consistirq of: lD~txibe spicially hlsricated materials separately)
Carrier Air Handlers PVC drains
Duct work - _ - _
Refrigeration copper _
wiring for equipment - - -
venting- for fans - _
on the following described real property in....tS.t-... Lucie - .county. Florida:
.
_ (Describe real Property sufficiently for identification. indudirtg stmt and number. if krwwn)
Sec. 21-35-40 .South 3/4 of West ~ of North 1/4 of South West 1/4
less West 40 feet 25th Street Ft.~Pierce
-Seminole_Springs Inc. - - ~ -
.owned by:
- 80/100 -
of a tote) value of .T??ret' thousand one hundred twelve -•-dolfara 3112.80••--- ) _
- of vEfiich them remains unpaid f ..:3112. $0 for which amoum Ire dsirns a lien on the above
described real property. -
-Hefurther sags that lienor famished the first of said labor. services or materials on AUgi13t••-168...1979
16th.----•-•--....19.79.... Arid the last of the same on..NOVe111bE~ 21 79.79..., and lif the lien
is claimed by one not in privity with the owner) that the lisnor served his notice to owner on....•-•.-•
. - (Method of Service) .
and, (if the lien is claimed by one nat in privity with the contractor) that tM lienor served a copy of his notice tt<
owner on -
(Contractor)
(Method of Service)
and additionally, (if ~:a lien is claimed by one not in privity with the subcontractor) that the lianor served a copy _
of his notice to owner on - -
(Subcontractari , .
on-. :......................ti~1i-_~-'3~- ~~-~..,'i. 19._...... ,by.............-•---.._.... lMethed of•Servics)
O `-r~ ~ERx CIRCWT COiIR Lienor
t . C .
a ? ~ io[CdRO Vf.Fsl'1L" ~G
,-t-• - ~ D ~ Sy ,
_ ; ~ ~ ._.......A ..nt
_ "
~ a:fl ~ subscribed before me this.__~~ ~ der of
- ~ ~Z•wu / .19.g
h~~ - .0:.
Natsry Public
1 his Inslrutnr~trl prrpnrrd b~•:South Florida Air Cond.
lrldrr~a 109E N. 29th Street -
Ft. Pierce, Florida ~ ~'TM~ ExAira Jay 17r 193 _