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HomeMy WebLinkAbout2327 . 4'~63U4 ru ~m rtewuMCr uu~ uw a lane ttAMCO FORM 120 f4 ~ l~aoul`.r ro: . ~ ~ Ltotar? Boiildiag Prodttate Before ms. the undereipned auatoriq. penona~r appM.ad _ who. beMp duly svrom, ssya that ne a tfte p.nor h.r.rn a th. a o» . a.rgr - - ~LC~i 80ILD~G P80DAQP8 (t.i~or's Name1 2201 S. B. Indian St. Port St. T~aaoie Flaacida 2 who.. address is ~....................3345............. It~isuar's Address) and that in pursunnq of a contract with ,~8'P1~40'tIQ~ ......................:........83~: ~~..s~.. frt. st.:..Lnat•~..Morsaa..~~452....... . lienor furnished labor. serviws or matetiab coraistin~ of: l~escrib~ spedn{ly tsbricat~d materiab separately) SI~IC:LB HtAiG 1~IFD0Y3 PALL VID Cdih'bR 3LID~1G GWSS D0088 ~P03r1D St~~t$ zxs7c~r~oa caa~$s on the tabwinp domed real property in .......................st~...I~npi~..---....................................cw,M~r. Florian: _ (Describe real property suifidently for identification, indudirq stmt and number. d kraMml 718 Hororost:, Port St. Lame, Florida 33452 - Lot 14, B(Loalc 377. ~b 6 owned by ....................F... Yu+LbRIO.............................................................................................. of s totalQliAe~4As. . t~~tT..l~B~. ~R1~~1J1'.~..B~..Q~tdbitars tti .~•A3Q..36 ....................1 of which tMn remains unpaid i....... I~~'fg!'.~.......... for which smount he claims a lien on tM above described real property. Hs further says that lienor famished the first of ssid labor. services a materiab on ...........9..27,++80 ..............18.........., and tM Isst of the same on.......12.~27.•8Q••........... ,18.........., and (if the lien is claimed by one not in privity with the owner) that tM tienor served his rwtice to owner on .........?-15-~ Certified bail - . (Method of Servical and, (if the lien b chimed by one not in privity with tM contractorl that tM lienor served a copy of his notip to owner on ~iQl'~'fS OGIIPYfl' ICo+rtnctorl on ~-15-fl0 ,18........... b~?............ QOC~ti t#~t~d. l~J6il , (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 notiq to owner on 4,344 (Subcontractor) on ,18........., Mr........................................................................... . (Method of Service) 19~ fE8 IS !~3 ~ 42 BUIL P~omtcrs - 0 Atip FECGt+Of 0 ! - Liertor r sy..... . i 'i.T•~ Sworn to sad subscribed before me ti~ - 15th ~ ~ ` ~ , ....................1 . ~ t....:... 8 ..t. ` _ Ps6ic. State of f~att'Pti,e!-, ~,q ~ ~ blic This Instrument prepared by: ~ r`_ ~f"~ N tea. r.. a . ' ~~j' ~ .lddresa ~ =