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r?A ~sn MccNAN~u RAMCO FOAM 120'•i
UEN IAW. fs 717M
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Before me, the undersigned authority, personally appeared . B....J.ame & -HayWOQd
who, being duly sworn, says that hs is the lienor herein or the agent of the lienor herein, .
- Artc~ Plumbing...Supplies.,...Inc.................. .
(Lienor's Name)
whose addressis.. ~QZ..S,.. ~.th..$treet,...Fort-- Pierce,- Fla. _33450
(lisnor's Address) .
and that in pursuance of a contract with....C.y$_t01I1..HOl1S.lllg_ SY$ temS , Inc .
lienor furnished labor, services or materials consisting ot: (Describe specially fabricated materials separately)
Plumbing Supplies
Copper tubing, PVC Pipe, Tubs, Lavatories and other relar_ed
material as ordered from time to time.
on the following described real property in S.t...LuCl~ County, Florida:
(Describe real property sufficiently for identification, including street end number, if known)
4621 N.W. 13th Avenue
Pompano Beach, Fla. 33064
Lot 27, Block 106, Section 27
_ '
owned by . .Jahn and. Ne.ien_.zngh.am...___
of a total value of One. Thousand...Thr.e.e.. Hundred Twenty.. oli ~s s~ _1, 3.20..21... )
~ f
of which there remains unpaid S ...~..r~-~Q. ~.2-1-.. - for which amount he claims a lien on the above i
~ described real property.
He further says that lienor furnished the first of said labor, services or materials on
Ptay..26 .19....$0 and the last of the same on ...July 30. , 19 $0 ,and (ii the lien
I'~ is claimed by one not in privity with the owner) that the lienor served his notice to owner on
I
July 2 _,1s_$0,by .....Cert-i.fied Mail_
. , ~ (Method of Service)
~ and, lif the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
owner on . CUlS.7;1?IIl .H.QU.S.~Ag_.$yS reins ZiIC:.
(Contractor)
on _ July 2.__ _ _ . ,1980.,by Certified Mail
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
i
of his notice to owner on _ _ _ _ . _ _
~ A p/~~~ (Subcontractor) .
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(Method_,of Sta~T1-• _ .
a9~0 t~`J3 •4 i~• 00 ~ _
~~I.I:o ~N~ Fcca~~i-a Artco. Plumbing_ ~~t~ t,.---~ia~~:,. - -
€ lienor ; ~ ~ _ `
St. L.UCIE CaUIiT Y. F l A.
ROGER P017RAS {
t,~CUIT COURT ~
BY ~
Agent =';,:r,
Sworn to and subscribed before me this _ T _ _ .......day of ~r 19 ~ •
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Notary Publi
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