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HAMCO FORM 12054
• t1J~ 1Np MtCNANICS'
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James A. Smith
8~ton m~. th~ und~rsi9rnd Natary Publlo. P~ncnally sppNnd .
who was duly swom and s~ys that h~ Is (th~ Ii~nor hKNn) ~~~~~gi]~~]{][~[r}~
IDEL N
Climatrol Sales Inc.
(Uena's Name)
3718 Interstate Park Rd, North, Riviera ~each, F1 33b 4
whosa address is . . :
. - (Lianor's Add~ess)
`T Mr. & Mrs. Stephen J. Johnson
and that in accordanc~ with a coM~~ot with .
~385 Mountw~ll St, SW, PSL, F1. 33452
.
lienor fu~nished labor, aervlces or materiels consisting ot: (Describs spscially tabricated materisis sepa~ately)
Fabrication and installation of a screen pool enclosure with
aluminum roof
St Lucie
on the following described real property in County. Florida:
(Desctibe real property suHiciantly tor identification, inctuding street and number, if known) -
Lot 6 Block 747, Port St Lucie Section Eighteen, Plat Book 13
Pages 17, 17A-17K, also known as 23g5 Mountwell St, SW, PSL, F1.
Stephen J. & Linda L. Johnson
owned by
ot a tota~ va~ue ot .ThreeThczusandFi veHundredSeventy-Fo.~~~ars (S ....3~.571~, 00
~ 1839.00
i of which thers remains unpaid ~ and fumishsd ths ~irst of th~ it~ms on
~ .....AUg.uS.t...2.1.._... 19...~_7...andthelastoftheitemsoa ..........~I~gUS~...21~..1Q.$7......, snd (if the li~n
i
is claimed by one not in privity with tne owner) that tha lienor senred his notice to owner on
_ 19.........., by ,
(Method of Service}
and, (if requiredl thet ths lisnor served copiss of th~ notice on the convactor on
by and on th~ wbcontractor................_.......................-•---.........................
(Method of Servics)
on.- ...............................................................19...........by......................................................................._...,
(Method of Service)
Climatrol Sales Inc.
nor - ~f! - •
~9
8,,~ ....age. ,.~~{~,,J..:.::.:.: ;,,.;::f.
9 ~ November . a~ ; `Y87
_
Swom to and subscribed before me t~?is ...............................day of .:..:',0.41'~"~...:-1
.
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. ~::.:.t " Notary Public ~ ,;r":r;%,
This /nslrum~•nl pr~•~ar~d b~•: James A. Smith ~tC
:,s;,:,~.~•"'`- .
~~~~~r~'~~ 3718 Interstate Park Rd, North '~f~=` ~
~J~1~'~r Riviera Beach, I'l. 33404
'87 hDV 12 P Z :31
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