501 Levy Rd ROOF21-0026 NOCDoc # 2021083137, OR BK 19658 Page 1153, Number Pages: 1,
Recorded 04/01/2021 09:10 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
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:'REPA"iE IN 6UPLCA'
Pon S(c!
State of E No. lar.Folio''.1�o0�_
State County oF_
To whom it may concern:
Me bridersiyr"ad herr' y b-4-nrs ycu t ;:., INiq be ,nrie to eartain realo•
sceot'&nce ufik section ;?s of a Ficeide s a rtes', the ;olio+Nsn�, St ' + ; P 'tY. atGt i c
GbiF3iJi4IdCltSi fd'i'. /s-onrcation !s sfaxc ±h :iris lVCi? iCrr f3'r
- , 1 descrMon of pro�erty IVing improvedy ew� - Q � F 0'::�
of
General
Address
Owners inierest in Site of the iml;;-aventar '
Fe•% simpia Tftlehokier (if other Than Deaner,';
i�arne
Contractor1tOMA�10 BR0 ROOFING Die - -
Address PO BOX 330337 AE:t-' TIC BEAE r_ 32233
Phone No. 904•24s•s84e - "--
_ _ .. fax No. 904-246-4810
Surety (If any, --_ _"_---------.,-._._ -
Address
Phone ND.
"— -- firnow)t of gond _
Pax Igo.
Name and
Nameaddress of err -�� - -- -- — '
J rer•sor i makIric a i027 ror *he construction of the improvements.
Address------_
ddress._ __ _- — T
Phohe No.
Fax No.
Name of poison within the State of cio:,de. zhan Nn. seif, ciss)gnated by owner upon wham noUcas or cijx
documents rnay se served
Name DANNY flONrANO
F ` Address LW �ii� SUi3 L "i3 d r __ __ �_-_ _
). _ __ !1C BIRR i iz� I L 32233 ---______._
Phone No. 804-610-0476
----_._-- Fax ido.----•-------_ """"--•-
In addHion io himself, owner designates the foito' • in
Section 713.66 t / ; - S Pe»n to recelve a eol�y Of the f-ieno"8 N011- as provided in
? I Florida Stac�tas.
Name Otvrer s option).
Address
phone No.
Fax Plc. '-'.�,.,--•
F-XVlrauon Date Jr Notice of: f:nlmencament the cX -'�•
diffarern late is specified): ( piration data is one (1) year from it a date of recoI
'ding Unless a
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signw:
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a r tree tmissF axr ikr m 6tot eN tem and d_ac/7�r— ---- �k� by
are true and ar+ urate
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