HomeMy WebLinkAbout04-4546Prepared by, recording requested by
and return to:
Name: Gary L. Rhoades
Company: Rhoades Construction Co.
Address: 239 S. 18th St.
City: Camp Hill
State: PA. Zip: 17011
Phone: (717)- 737-9291
Fax:
.................. Above this Line fct Official Use Only ....................
Claim of Lien -- Individual
(Pa. Stat. Ann. tit 49, § 1503)
COMES NOW, Gary L. Rhoades , as a ( X ) contractor ( ) subcontractor
who has provided labor and/or materials for the alteration, repair, erection, or
construction of the property located at and described as
A Bi-level, Single Family, Residential Dewelling , and would state as follows:
1. The above-described property is owned by or reputed to be owned by 2' .. Barbara
Furbush , who may be reached at the following address 820 Lisburn Rd. Camp
Hill, PA. 17011
2. The undersigned ceased furnishing labor and/or materials on the 17th day of
June ,2004
3. If the undersigned is a subcontractor, labor and/or materials were furnished under
an agreement with contractor, . If required,
a Preliminary Notice was provided on the . day of · 20
A Formal Notice of Intention to Claim Lien was provided to the property owner on the
day of ,20__
4. If the undersigned is a contractor, labor and/or materials were provided under a
contract with the property owner executed on or about the day of
20 , for the furnishing of the following labor and/or materials:
Labor/Materials Furnished Date Furnished Value/Cost
531 Man-hours 5/13/04 thru 6/17/04 $10,620.00
Material 5/13/04 thru 6/17/04 __.$3,869.14
5. The amount due the undersigned for said labor and/or materials is
Three Thousand Seven Hundred Eighty Nine and ..... ,00
$ 3,789.00
This the _9th day of_September, 2004
Signatu~
Acknowledgment of Individual
STATE OF
COUNTY
me ~ dq] ~ ~c4~.. ~..~,f'~O-~e'~ ' ~ the ~d~si~ o~c~, p~so~lly
app~d~~~ '~ ~ - , ~o~ to me (~r safisfmofily
prove) to be ~e per~n wh~e nme /~, ~bscnbed to the
Mt~n instrument, ~d ac~owl~g~ ~t ~. (h~sh~they)
exe~ ~e ~e for ~e pu~s ~ein cont~n~.
In witness whereof, I hereunto set
~ T~., Combo~a~ C,O u ri'o/
1~ ~ E~ ~u~ 5, ~
my hand~_~d official seal.//') _ (-~
My Commission Expires:~.j..U ~fD7 ~O (~
Certificate of Delivery
I, L, /~J./f~,d~:~ ,herebycertifythatlhave
delivered this day a tree and correct copy of the foregoing to
t~,'q,t(g/'J~ HU~ffU~/-J by:
(X) Personal Service
( ) Mailing a tree and correct copy of same by first class registered or
certified U.S. mail, postage prepaid, return receipt requested to
So certified this the
day of
Sp"',r 6,qg£',4 ,20oc/.
GARY L RHOADES
CONSTRUCTION CO.
~gS. 15~ s~
Camp Hill, PA. 17011
Barbara Furbush
PHONE: 7:57-9291
E-MAIL: localgay(~ezonline.com
INVOICE
DATE
7/6/2004
DESCRIPTION
Property
2710 Harvard Ave.
Camp Hill, PA. 17011
Complete Basement Renovation Including:
Ceilings, Walls, Carpeting, Ceramic tile floors, Doors, Bathroom, Plumbing,
Electrical, Countertops, Painting, etc.
Tile in Hallway, Carpeting on Stairs.
Ceramic Tile on Kitchen Floor.
Misc. Painting.
Repointed, Brickwork on exterior.
Cleaned up job site and hauled away debris,
5/13/04
5/27/04
6/9/04
8/8/04
Total
Payment
Payment
Payment
Payment
AMOUNT
$14489.14
-$3000.00
-$2000.00
-$4000.00
-$1700.00
Thankyou,
GaryL. Rhoades
Total Due
$3789.00
VS.
In 'the Court of Common Pleas of
Cumberland County, Pennsylvania
NO. Oq -- ~/~"-{7r~ ~{"'{~ Civil. 19
To
Prothonotary
Attorney for Plaintiff
No. Term, 19 __
Filed
PRAECIPE
19
, Atty.