HomeMy WebLinkAbout1572 SU9654 -
ru Isar wtcwuecs RAMCO FORM 1205
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~ St. Lucie _
eetore ms. the undersigned suthority, personally sppesrsd ....8.,....jades...Hq~1.WDOd
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who. being duly sworn. says that he is the lienor herein or the agent of the lienor herein, .
Ar tco•. P lumb•ing.•.Supply-, ..Inc..
Otenor's Name) ~
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- whose address is ...642•••S...-.•5•th•••S.treet,...-.F.t...Pierce.,...Flor.ida.....33450
(Lisnoi s Addnsal
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andthstinpursuanceoiscontrsctwith.....GUS•tOt&••HOtlf3ln-g•••S~LS•tell),----InC•.••••-•-•••••••••.-------•--•-.-~•-•••.
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- lienor furnishedgl}Le~rx~~g( 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.
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on the following described real property in....s•t•;•••LuCie---~•••--•--• .......................•--•-.--.............County. Florida:
(Describe real property sufficiently tar identification, including street and number, if known?
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Lot 30 1st addition - Skyline Park - f
2651 Savannah Road }
Jensen Beach, Florida 33457
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owned by---Go.lin...~..-B.rigid..Carr E
of a total value ofQ[le.. ~1~QUS.and...4ne..~ut~dred.-.Forty.--.Sevet~& rs
(~s~-100 1-,147.49.---.~ `
of which there remains unpaid 5.--...~.a.14.7.49
.:........................for which amount he claims a lien on the above
described Taal property.
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• He further says that lienor furnished the first of said~~~pE materials on ,
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Augu.s.~...0.7 .19..$Q.., and the last of the same a,...September, .01 ,1x•.80--, and (if the lien
is claimed by one not in privity with the owner) that the lienor served his notice to owner on _ ;
July--29 ........................19.8.Q...,by...Cer.t~.~~:~.d..~"~~1.~..:-
(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 ...............Custom..Housing..Sysrems•T---Inc-......-----...- .
(Contractor)
on Judy-..2y ,19..8.0--• br---~:er.ti.fied-.Mai-~...------.......................... ,
(Method of Service)
3 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
Sn~~CA (Subcontractor)
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on QL ,19........... b .
r (Method of Service)
st.«cli: ca;N~Y.l1~. .Artco..Plumb.i.ng..Suppl.~..-.:TnG..
ROGER POITRAS
{ CLEFK ClRCU1-T~Cft,'L~R Lienor -
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Sworn to and subscribed before me this ` of ~Y ..a~&~ r '~~~C•- • ~ ~,8--:
NOTARY PtJ?LI ~ J .
5~.,._ OF J8 f~A -
R I ~t lel~ a
h:YCG'Sn.";iv;Jf,':'~:~'; ccpr 21 1483 `
~O::c,t~ t~~:.~ _ , t'... :,„AI Notary •Py - , .
"!'his Instru??ttvtf prrpnrwl hr: ~ ~ _
Patricia N. Clark ~ ~~-i• .
~Idlrrss 602 S. 5th Street •
33~~~~ ~~r,~l~~ Ft. Pierce, Florida 33450
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