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ru u» MECwuucs• ~ IIAMCO FORIIII 1201ti
ueN uw. rs actor
~y1832
of tB Brevard ~
Before me, tM undersigned authority. personally apparel ......G EtQ.t$.R...~o~?.~AkO..........MA=4g$ eT,......
i
who. being duly sworn. says that M is the lienor herNn at the went of the lienor herNn .
.....Climat.ro.l.-.Salsa......Inc
(lienor'a Namel
whose sddress is ...............5.29...S-..Iadus.tr.K...R,aad.........: Cacma....Florf.de....................................
IUenor's Address)
and that in pursuance of a contract with Larry..... Barninger•... .
. 5405 Susan Lane.•.••...••_.-Ft.. Pierce.~•.•Florida
lienor furnished labor, services or materials, consisting of: (Describe specially fabricated materials separately)
Fabricaton and installation of screen pool enclosure
on the folbwing described real property in S t-.-LuC ie ......-•-.------County. Florida:
(Describe reel property wfficiently for identification, including street and number, if known)
5405 Susan Lane Ft. Pierce, Florida
Lot 49 .Holiday Pines S/ D
owned by .............Larry.. Barninger..----........-----•-------................--•--•--................-•---..........-------•---............
of a total value of .laenty-one hundred fifty dollars li 2150.00 ~
of which there remains unpaid =........14 S 0•,.00-•,.•,...•..• for which amount hsclaims a lien on the above
described real property. .
He further says that lisnor famished the first of said labor, services or materials on
,19.........., and the last of the same on........................................ 79........... and (if the lien
~ is claimed by one not in privity with the owner) that the lisnor served his notice to owner on
• 79....--...., by..-...........................-............................................................................--.-
(Method of Service)
end, (if the lien is claimed by one not in privity with the contractor) that the lienor served. a copy of his notice to
owner on
(Contractor)
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on
(Subcontractor)
on.........- ,19.........., by.........................-•-------...---................................... .
A A.~ p'~ (Method of Service)
't.71oa71fr ......C1•itn ....:o1...S.ales...Inc-------•----•--...-------•----
19$0 Jl1L -7 ~i il= 16 ue ti
5 RO~G
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;e ~ Notary Publ'
i f~! _ Pd 6~•:George Bobinko
`;p.. 529 S Industry Rosd (tj~C~cc~~
• ~ - . Cocoa, Florida 32922 SO~O1R(~`t PAGE ~eJJ