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BEFORE ME, the undersigned authority, personally appeared ...WILLIAM A. IiOGERS
who, being duly sworn, says that he is the lienor herein
for the agent of the lienor herein), Adobe Building Centers, Inc. whose address is
2056 Scott Street, Hollywood, Florida 33020
1 Lienor's Address)
and that in purwance of a contract with LOU RANTUS
lienor furnished labor, services or material consisting of: (Describe specially fabricated materials
separatelyl.
Drywall materials, metal framing materials, screws, miscellaneous
small tools, equipment rental and services and plastering .materials. ~
of a total value of .,,ONE THOUSAND, TWENTY-0NE and 91/100 pollars
.1...Q.~.1...9.1..........1 of which there remains unpaid S~ ~.s 4 ~ ~.s.~ for which amount he
claims a lien on the following described real property in ..ST....l.UC.IE County, Florida:
(Describe real property sufficiently for identification, including street and number if known)
Lot 26, Block 100, LAKEWOOD PARK, UNIT 8,
according to the plat thereof recorded in Plat
Book 11, Page 19, of the Public Records of St.
Lucie County, Florida 494943
X80 ~(JG -4 NK ll: 2 ~
a/k/a Brookline, Fort Pierce, Florida . Fr.:p ~?C F~cc~DEu
51. lIJC1E C~'lA1tY ftA.
ROG~ POITRAS
CLEWI C1RCfllT CWtNT
' VICTOR and ANNA HUMPHREY r
~ Owned by .....................................................................................f.cr.F~ :.r~:~:~~':.:.
April 17,
He further says that lienor furnished the first of said labor, services or materials on
30 ~ May 8, 80
, 19........., and the last of the same on 19......._., and (if the lien is
claimed by one not in privity with the owner) that the lienor served his notice to owner on
Maur 6, , 19 80 , by Certified Mail and if the lien is claimed by a wb-con-
(Method of Service)
~ tractor or materialman to wb-contractor) that the lienor ,served his notice to owner on the privity con-
e
19........, b ~ and if the lien ~s claimed
tractor on N/..A N A ( -
y
(Method of Service)
by a materialman to a wb-subcontractor) that the lienor served his notice to the wbcontractor on
N/A N/A
19......... by -
(Method of Service)
ADO B ING TE ,INC.
c
By
I lienor or Authorized Agent
-
_ '
SWORN TO AND SUBSCRIBED before me this .~.St... day of July 80.
~ ............................f,- _ .
•
RECORD AND RETURN TO: Notary Pubiic, of Florida
TH03fAS R. SRAA:IDY H~-~~? ~ `
' T/~is /nstramerrt prepared by: `IEZZANI~E - I~TER_1ATIO~AL BLDG. fey Coarr.:zsi,~ laY 20ct1~2_
245 EAST SL:~R/SE BL1'D.
b(1!)K~ P11GE T„ PT. LA[.'DF.R~ 1T.F„ FLORIDA ?330-i
.
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