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54453
ru? ~~iy ~ccwu+ECS• RAMCO FORM 120 Y,
ueN u:w. rs nsa
. - ~tl~tim ~t~n
of St. Lucie
eeiore me, the undersigned authority. personally appeared .........8....J~me~.. ~A.y~1.Q.P.d ~
i
who. being duly sworn. says that hs is the lienor herein or the agent of the lienor herein, .
Ar.t~o...~.~umb~ng.. Supply....Inc . `
IUenor's Nams)
whose address is...6.O2.-S.-..S.th....StxeeL.,.....~z......P..i.e.XC.~.,...Florida..--..33450•-.--•
(Wnor's Address)
and that in pursuance of a contract with...Ci11S•t0>a..HOt131.n,g...s}1.8.tC1l~S.,...~~1C .t .
lienor iumishedK7~}pt materials consisting of: (Describe specially fabricated materials separately)
Plumbing-Supplies -
Copper Tubing, PVC Pipe, Tubs, Lavatories and other related
material as ordered from time to time.
on the following described real property in.... $ ~.r....~+uCle .................................................:......County. Florida:
(Describe real property sufficiently for identification, including street and number, if known)
Lot 1 Block 237 Section 28
1290 S. W. Bayshore Blvd.
Port St. Lucie, Florida 33452 -
owned by- --Leo...&. ,A]l1Tl...~l~~~~..III
of a total value of ..-Faur...Hundred.. ~xilexlty-Two..-l~.--~~./ 100..... dollars Is ..422_..55 .
of which there remains unpaid s ....422...55 for which amount he claims a lien on the above
described real property.
He further says that lienor furnished the first of saidi~NL~ifi3f+1WE7tiKmaterials on
f Atlgu9, t... 2.5 • 19...$Q, and the last of the same on.... ~1uguS.t...2'.7 . 19 ~.Q..., and lif the lien
' is claimed by one not in privity with the owner) that the lienor seared his notice to owner on '
s Augu.st...~6 ...................,19..80..by--•.Certified...Mail - -
(Method of. Service)
and, (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..........C.ustom.-Housing--Systems.,...Inc.,
(Contractor) ,
6rugust...2.(~ ................................•---.....------.......19....8.u., by.....CertiYed-.Mail....----- -
IMethod of Service)
and additionally, (ii 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)
50465
- ~s~D O~:T 24 ~~f 2g (Method of Service)
a ~ - is
F?l.ED tNt' cc~1 i a Ar.tca..Plumb.i~ng..Supply:,....Inc.,
S1.ltlCfi'tC±'NTY.I~ A - - ~
€ ROC£R P(JITRAS Lieno~
Agent - - r..~
g;. ~
- ~ .y ~ F
Sworn to and subscribed before me this of ...f? ,_~.~_....;.~:;.`.,+1
- 0 ~ ~ -
NOTARY PU'sC;C SiAT~ pE fl-ORIDA AT LARGE ~ ,
,L, Notary p~ . - 2:.,~:~~.:
)'his /?tslnt?nr~nl prrpnrrvl hi•:.~ Patricia N. Clark ~ f'"'
4 ;
ap;t_ l ~;r,.,
.-lddrrsx b02 S. 5th Street _ ~ ' "
g~~X P..,E F t . Pierce , Florida 33450 -
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