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Building & Code Regulation Division,;
2300 Virginia Ave
- - - -- - - Fort Pierce, FL 34982
772-462-1553 Fax 772-462-1578
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ASBESTOS NOTICE TO CONTRACTOR
Date: 3 17
Contractor Name: R (�l
Business Name:
Address:
City: i State:
Zip Code:
Re: Job Address: '181 S C _ �Ab QL- &-y
It is your responsibility to comply with the provisions of Section 469.063, 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.
Signature ate
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