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2300 Virginia Avenue
fort Pierce,FL.34982'
Phone:(Tl2)462-2772 Fdx: (772) 462.8443
Asbestos Notice to Contractor
S
December 05, 2016
SIEGEL DESIGN GROUP INC
ROY M SIEGEL
9268 PALOMINO DR
LAKE WORTH, FL 33457
RE: Building Permit Number 1612-0057
It is your responsibility to comply with the provisions of Section 469.:003, Florida Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
S' ature
Date
12/5/2016 9:32:55 AM