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JL
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-1553 Fax 772462-1578
DEC 0 5 201.7
ASBESTOS NOTICE TO CONTRACTOR P E 13-"A 117 HNIG
St. Lucie County, FL
Date:
Contractor Name: Civv) 14 5 t('IO X111 67
Business Name: C bi) tfmlls CGA1&6((Y-6?-
Address: 9 v /j
City: Ly��a e.l' State:
fl-
Zip Code: 3,:-),:?6-
Re:
Re: Job Address: r�� tL • .'5'e
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.
Signature & Date