1997-1210_ALL AMERICAN ASPHALT_Preliminary Notice FORNIA PRELIMINARY NOTICE / FOR OFFICIAL USE ONLY
YOU IRECTED TO SECTION 3097,3096 AND 3111,CALFOI L CODE WHICH REQUIRES US TO NOW( q (ti/'1 A
YOU'T NOT PAID IN FULL FOR LABOR.SERVICES,EQUIP' MATERIALS FURMSHED.OR TO BE FUR- 'LIT VM LJ�l4l
NISHED,THE IMPROVED PROPERTY(WHICH IS DESCRIBED HEREON)MAY :T 10 MECHANICS'LENS'(THIS STATE-
MENT IS APPLICABLE TO PRIVATE WORK ONLY)
THIS IS NOT A LIEN.THIS IS NOT A REFLECTION ON THE INTEGRITY OF ANY CONTRACTOR OR SUISCONRACTOI,
Instructions: A. Fill out form completely and legibly.Use typewriter 6 possible.
8. Assessor's parcel number may be obtained from the County Assesses.
C. Top,original signature copy may be Med with the County Recorders Office pursuant to
California Civil Code Section 3097(0).
DATE ASSESSOR'S PARCEL NO. J
YOU ARE HEREBY NOTIFIED:
THAT THE UNDERSIGNED HAS FURNISHED OR WILL FURNISH LABOR,SERVICES,EQUIPMENT OR MATERIAL OF THE FOLLOWING DESCRIPTION
\
CrAPES BA.CT:I:OE SERVICE INC. 1 ronstructiol-
(NAME) (DESCRIPTION OF LABOR,SERVICES,EQUIPMENT OR MATERIAL)
3141 Electric Ave.
(ADDRESS)
INDIVIDUALVIStantgn CA 90680 Preventive Street Naint. Varioas Loc
FIRM (CITY) (', (STATE) (]P)
BY: '_ ,I" e ?'i a -i ttr, i'1 1 1 n T`r
(SIGNATURE) (ADDRESS OF BUILDING,STRUCTURE,WORK OR IMPROVEMENT)
Shirley helger Secretary 12-10-97 San Tuan Capistrano CJ" Job 7672
(TITLE) (DATE) (CITY) (STATE) (7P)
1 0
THE NAME AND ADDRESS OF THE PERSON WHO CONTRACTED FOR THE PURCHASE Of SUCH LABOR,SERVICE,
EQUIPMENT OR MATERIAL,IS: All American P,snhalt ESTIMATED TOTAL PRICE OF
(NAME) LABOR,SERVICES,EQUIPMENT $10,000.00 Annrox
OR MATERIALS DESCRIBED HEREON.
(ADDRESS)
NOTICE TO PROPERTY OWNER
(City Of San Juan Capistrano If bills are not paid in full for the labor,services,equipment,
(NAME) or materials furnished or to be furnished,a mechanic's lien
32490 Paseo Adelanto leading to the loss,through court foreclosure proceedings,
TONER, (ADDRESS) of all or part of your property being so improved may be
REPUTED OWNER,
,l
OR .:a.n JuanCanistrano CA. 92F75 placed against the property even though you have paid
PUBLIC AGENCY your contractor in full. You may wish to protect yourself
`
(CITY) (STATE) (BP) J against this consequence by(1) requiring your contractor
to furnish a signed release by the person or firm giving you
this notice before making payment to your contractor or(2)
any other method or device that is appropriate under the
circumstances.
A1.1. American Asnhalt
(NAME)
TO: '' .0. Box 2229 TRUST FUNDS TO WHICH SUPPLEMENTAL FRINGE BENEFITS ARE PAYABLE
ORIGINAL
CONTRACTOR (ADDRESS)
REPOUTED Corona CA. 91.719--2229 NAME 1.11.0.E. #12
CONTRACTOR
(CITY) (STATE) op) J
/ ...\
ADDRESS
/ \ NAME
l (NAME)
TO: ADDRESS
CONSTRUCTION
LENDER (ADDRESS)
OR NAME
REPUTED
CONSTRUCTION
` LENDER (CITY) (STATE) (UP)
.. J ADDRESS
(MATERIAL MEN NOT REQUIRED TO FURNISH THE ABOVE)
PROOF OF SERVICE AFFIDAVIT
(SECTION 3097.1,CALIFORNIA CIVIL CODE)
I, 5i-ir1 cv TtP`I?e', ,declare that I served copies of the above PRELIMINARY NOTICE(check appropriate box).
(a) ri By personally delivering copies to at
(norne(s)ones Elle(s)of person served) (address)
on 19 • atm.
(dale) (ILme)
(b) By First Class Certified or Registered Mail service,postage prepaid,addressed to each of the parties at the address shown above
T 7
on - • 19 .
I declare under penalty of perjury that the foregoing is true and correct.
--
Signed qtantor –_-- —_--•California,ons _ , 19�
[ATTACH RECEIPTS OF CERTIFIED R REGISTERED MAIL WHEN RETURNED] > -i-<_- .e..e, '.
.,
SIGNATURE OFIPERSON MAKING SERVICE
REDIFORM. 4P449 POLY PAK(50 SETS) r C Mil=CI f`f'SDV