HomeMy WebLinkAbout0392 SU`~382 ~f ~
nA »77 M[cNANiu RAMCO FORM 1T0'.
U[N lAW [S 7110
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,Mats of ~(losiDa 1 .
alou>~ of j
EVERETT M. CHAMBERS
Before me, the undersigned authority, personally appeared
who, being duly sworn. says that he is the lienor herein or the agent of the lienor herein,
EVERETT M.CHAMBERS
(lienor's Name?
whose address is 131? PARKLAND BLVD. FT . PIERCE , FLORIDA , x'3450
(Lienor's Address)
and that in pursuance of a contract with M~ • @_MRS. DELGADO
2191 S.E. SUNFLOWER STREET, P.S.L. FLA. j345o ( copy to j2-35 30th,
G[~+
ftfiA~~ist~'1~tlbt'S~rviL~S'dt`fi1at~ cbirSit;'iin~8f•-~scribe specially fabricated materials separately)
b'IATERIALS WOOD PRODICTS ,ROOFING t~tATERIAL, PLUMBING, ELECTRICAL,
INSULATION MATERIAL AND LOBER , DRYWALL MATERIAL AND FINISH, PAINT
AND LABOR CONCRETE AND FINISH IaBER , FORM WORK PLACING STEEL,
SLIDING GLASS DOORS REh10VAL OF WINDOWI AND RELOCATE PER OWNERS
INSTRUCTIONS, ALSO RE2rI0VE AND RELOCATE POCKET DOOR. CUT DOWN INTERIO
-WALL TO HALF HIGH. LABOR FOR PORCH AND BATH WITH EXTENION OF MASTER
A'rftKA'ft;RA~lrirYgD~~~Crilfdttfe~~~ertyYA`... FUTURE, DINING. County. Florida:
(Describe real property sufficiently for identification, including street and number, it known)
2191 S.E. SUNFLOWER STREET PORT ST. LUCIE, FLORIDA 33452
LEGAL DESCRIPTION OF PROPERTY LOT 16 BLOCK 107 UNIT five
i~[R . AND PAS . DELAGDO
owned by
TIME AND 1ATERIAL
of a total value of dollars IS 1
i
of which there remains unpaid S 7 ~ 45$., 69 ,for which amount he claims a lien on the above
I
i
described real property.
w
He further says that lienor furnist:ed the first of said labor, services or materials on
s
-5 , 19 ~0 and the last of the same on 9-25 . 19 ~0 ,and (if the lien
~ is claimed by one not in privity with the owner) that the lienor served his notice to owner on
.19 ,by
(Method of Service)
and, (it the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
1
1 owner on
(Contractor) .
on ,19_ .by.
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontracto?) that the lienor served a copy ,
of his notice to owner on
(Subcontractor)
rdONTHLE'Y STATEMENT COMPLETION 0 JOB. #
on 10••21 - • ~ 9~0 . by EVERETT M. CHAMBERS (CONTRACT )
S(k~•2p~, IMetho of Service) '
i ~ : ~ ~ ~ ~ (!1 ~~7ff` ttKK77ff~`rr f~ ~U'~1r~ ~G.--x 9~N/'~
4 ~ Lienor
fay ~~+~.5.
~ _ _ _ ' • t • Agent
Sworn to and subscribed before me this ~ / ~ _ ;:,day of ~ . ~/~~~I~~ 19
Notary Puf:S',c. State ei F!r,cta. at Lxg= i~'~~~/J
L:~ :•~^,:.:s:::.,;
n.:., „ . ~ ~i.ar NO y Public
I'/ric Irrslrrrnn•r?? /rrr•purrrl ~t~:
~ trlrlr-r•.. EVER~TT Td. CHAMBERS 131? PAR~~.ArrU ~OLVD. FT. PIERCE, FLA. 334 ~
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