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i p /'� ^ �jj�'� 'T � <br /> } V�� 3. V� ��AMA��,1������}.a..1� <br /> . Q J <br /> � "`�" "City of Pure Watex" <br /> Building Department <br /> ' �` 5335 Eighth Street•Zephyrlulls,Flarida 33542-4312 <br /> (813)780-002Q•Fax(813}78Q-0021 <br /> W.A.`Bill"Burgess <br /> Director of Building <br /> Licensing&Zoning <br /> Contractor Asbesto� Nonfication Statement <br /> Per Florida Bt,Wdin�Code 105.9 As6estos. The enforcin�;a�ency.shall rec�uire each buildin�nesmit for <br /> the demalition or renovatian of an existing structure to contain an asbestas notificatian statement which <br /> indicates the owner's or operator°s responsibilitv ta camplv with the provisions of Section 469A03 <br /> Florida Statutes,and to notifv the T►epartment of Environmental Protection of his or her intentions to <br /> remove asbestos.when annlfc�bte,in accordance with stat+e and federal law. <br /> 4b9.OQ3 License Reqmirecl– <br /> 1. No person may conduct an asbestos survey,develop an operation and maintenance plan, <br /> or monitor and evaiva�e asbestos abatement unless trained and licensed as an asbestos <br /> cansul�ant as required by this chapter. <br /> 2.(a) No person may prepare asbestos abatement specifications unless trained and licensed as <br /> an asbestos consultant as required by this chapter. <br /> (b) Any person engaged in the business of asbsstos surveys prioz to October 1, 1987,who <br /> has been certified by the Department of Labor and Employznent Security as a certified <br /> asbestos surveyor anc!wha has complied with the training requirements o:f S. <br /> 469.013(1)(b},may pravide swrvey services as described in S.255.553(1),(2)and{3}. <br /> The Department of Labar and Employment Security may,by rule,establish vialations, <br /> disciplinary pracedures,and penalties for certified asbestos suzveyors. <br /> F � <br /> 3. Na person may conduct asbestas abatement wark unless Iicensed by the department <br /> under this chapter as an asbestos contractor,except as otherwise pzovided in this chapter. <br /> I certify that I have read and understand and will comply with the pravisions of this asbestos notification <br /> statement and that 1 will comply with all state and fecleral regulations pertaining to asbestos. <br /> i <br /> �4 � � <br /> , -�� <br /> Li nse o r o actor Signature � Date <br /> ! <br /> a <br /> �.- �-- C.-.- �' �.-L� ��--� � -a �t �-I '1� ' <br /> License Halder/Cantractor rinted Name t License Nunnber j <br /> � � <br /> � �l � { � �aU ��i � � � i � <br /> Address of Construction Site ' � <br /> ri <br /> �� <br /> X <br /> ��� � � � R; <br /> Permit Number � <br /> � <br /> . �� <br /> . 4' <br /> � <br /> ., <br /> � <br /> __. —_ <br />