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- ' CITY OF ZEPHYRHILLS <br /> . <br /> ;� "City of Pure Water" <br /> Building Department <br /> 5335 Eighth Street•Zephyrhills,Florida 33542-4312 <br /> (813)780-0020•Fax(813)780-0021 <br /> W.A."Bill"Burgess <br /> Duector of Building <br /> Licensing&Zoning <br /> Contractor Asbestos Notification Statement <br /> Per Florida Buildin�Code 105.9 Asbestos. The enforcins aeencv shall reauire each buildinQ uermit for <br /> the demolition or renovation of an existing structure to contain an asbestos notification statement which <br /> indicates the owner's or operator's resvonsibilitv to comvlv with the provisions of Section 469.003, <br /> Florida Statutes,and to notifv the Denartment of Environmental Protection of his or her intentions to <br /> remove asbestos.when anulicable.in accordance with state and federal law. <br /> 469.003 License Required— <br /> 1. No person may conduct an asbestos survey,develop an operation and maintenance plan, <br /> or monitor and evaluate asbestos abatement unless trained and licensed as an asbestos <br /> consultant 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 asbestos surveys prior to October 1, 1987,who <br /> has been certified by the Department of Labor and Employment Security as a certified <br /> asbestos surveyor and who has complied with the training requirements of S. <br /> 469.013(1)(b),may provide survey services as described in S.255.553(1),(2)and(3). <br /> The Department of Labor and Employment Security may,by rule,establish violations, <br /> disciplinary procedures,and penalties for certified asbestos surveyors. <br /> 3. No person may conduct asbestos abatement work unless licensed by the department <br /> under this chapter as an asbestos contractor,except as otherwise provided in this chapter. <br /> I certify that I have read and understand and will comply with the provisions of this asbestos notification <br /> statement and that I will comply with all state and federal regulations pertaining to asbestos. <br /> �z z�/ <br /> License Holder/Contractor Signature Date <br /> /v�-� fvU�� � L v�t� <br /> License Holder/Contractor Printed Name License Number <br /> �l � o z� �- ����� <br /> Address of Construcrion Site <br /> / ! l / J <br /> Permit Number <br />