HomeMy WebLinkAbout0991 _ a.. ~
Doby Supply sa~a~8~y ~
P.O. 8ox 2906~ Vero Beach, F1a.32960
r~• If77 MECNAMICt RAMCO FOqM 1?OK
uEw ~~w. rs naa
~l~x`ti~t ~a~ ~`t~rt
_ ~
~aunt~ of Indian River ~
6etors me. the undersigned sutho~ity. psrsonally appes~ed ....DaY.1d..K1~lS.
. _ _
who, being duly swom, says that hs is the lienor heroi~ or ths aye~t oi the lis~o~ heroi~, .
Treasure Coast Supply~ D/B/A Doby Supply
. . . _
_ _ .
(lienor's Name) ;
1971 Commerce Avenue~ P. 0. Box 2906, Vero Beach~ Fla. ~
whose address is . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . _ . . . . . . . . . . :
, (Lisnor's Address) ~
and that in pursuance of a contract with . _ _ _ ACt10ri DZ'~1.W31.1.. _ _ _ _ . _ _ ,
. . . . _ _
_ - ,
lieno~ tur~ished labor, aervices or materials consisting oi: (Describe specially fabricated mate~ials separately)
i
~
Drywall and Drywall Materials ~
:
~
3
on the following described real property in _ ~,1~~ . _ . _ . _ . _ County. Florida: ;
(Describe real property suHiciently for identitication, including street a~d numbe~, ii known) ;
i 611 SW Fredrica Street ~
- ;
Port St. Lucie, Fla. -
I,ot 2 Blk 82 Sec 27
ow~edbY .Steven Perusk_i... .
_ . . . . .
_ . .
_ .
; ot a tocei ~ei~e ot Five Hundred Eighty .Four_ & 16/l~i~a~s 1s ....58~ ~.16
_
~ 84.16 =
I of which there remains unpaid S........5 for which amount he claims a lien on ths above -
~
j described ~eal property.
He further says that lienor furnished the tirst of said labor, services or materials on MSY'Ch
. . _ _
. 26th . 19 , and the last of the same on. A'1ax'Ctl Z6 . ,19 ~a. and (it the lien `
i
is claimed by one not in privity with the owner) that the lienor served his notice to owner on _ _
~ May 9 81 Certified Mail~
~ _ _ . _ , ts _ _ .5y _ . . . . . . . . . . _ _ .
(Method of Sen+ice)
il
and, ~if the lien is claimed by one ~ot in privity with the contractor) that the lienor served a copy of his notice to
i owner on . -
, _ _ _ . . _
(Contractor)
on _ _......._...._._..,19__..._.by . _ . •
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcont~actor) that the lienor served a copy
of his notice to owner on _ . . _ . . . . . . _ . . _ ~
(Subcontracto?)
5~338~9
~24
_
on ~~i~ ,19.__ .by...... ~
~ " ~ ~ (Method of Service) i
F'= Ec t'+~ "~v~; Treasure Coas~ Supply, d/b/a Doby =
S~.i~;r.cF tG';N~y.ft:.. . _ ;
~?c:CER rc~r~;:. ; Lienor Supply
' ciE,+~ cF~::~~, e_~:~ _
~i . - _ ~ gy.,'~ _
, f~"""'
- , : _Agen~
r y
. ~ .
Swom to and subscribed before me this__.__ ~t}±h __day of ~~r'•e . i'~ 19 _ '
_ . . _ . _ _ ' ; ~5~'F!!
.Y J . L->t~ ` _ . , i
Notaljr P , lic ~ s
%'his Jn.lru~n~rnl pr~•parrd hv: Ilvi S2irony
:1 dilrrss t.otary Pu51ic."'S~ate 6F -Fla~~ • al
1971 Commerce Avenue ~ ~ Co;~;n~s.~op Q~cq~jes lan. ~:'1~aY p~ 2~Q ~
i"o Beach , F11. 32960 ~:.`.'id r~. !•t:cw.a;o.w••r ~~K!J~J~7 P1ICF
J fi~ a~
F
~ - = ~ ~ - :
~ ~ ~ - ~ ~
" ~s~a~~~~~,~~_ ~