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� � <br /> ' t�ITX U. ZEP��E�TL�,L� <br /> .o � <br /> � "Gi af Pure Water" <br /> Buil ing Department <br /> � � 5335 Eighth Str et•Zeghyrhills,Florida 33542-43I2 <br /> �ai3 �a -oa2o•��(ai���so-aozi <br /> W.A."Bill"Burgess <br /> Director of Building <br /> Licensing&Zoning <br /> Contr�c�e�r Asbestos I�o 'fication Statement <br /> I'er Fiarida Buiidin Code 105.9 Asbestos. 'I'he enfor ' a ene shall r uire each huildin ennit for <br /> the demolition.or renovation of an existin structure to c ntain an asbestos notificatian staxement which <br /> indicates the owner's ar o erator's res onsibili to com l wi#h the avisions af Section 469A03 <br /> Florida Statutes and to noti the De arimen�of En ' nmenta�Protection af his or her intemtions to <br /> remove asbestos wl�em a lic�bl in accorc�ance wi st�te�nd federat Iaw. <br /> 469.Q03 I.icense Reqzairedl— <br /> 1. No person may canduct an asbestos surv y,develop an aperation and maintenance glan, <br /> or monitor and evaluate asbestos abatem nt unless trained and Iicensed as an asbestos <br /> consultant as required by this chapter. <br /> 2.(�� No person rnay prepare asbestas abatem nt specificarions unless trained and licensed as <br /> an asbestas consultant as reqnired by thi chagter. <br /> (b) Any person engaged in the business of as estos surveys prior ta October 1, 1987,who <br /> has been eertified by the Department of bor and Employment Security as a certified <br /> asbestos suxveyrnc and who has complied 'th the training requirements of S, <br /> 469.013(1)(b),may provide suzvey servi es as described in S.255.553(1),(2)and(3}. <br /> The Department of Labor and Emplaym t Security may,by rule,estabiish violations, <br /> disciplinary procedures,and penalties for certified asbestos surveyors. <br /> 3. No person may canduct asbestos abatem t work unless]icensed by tlle department <br /> under this chapter as an asbestos contract r,except as ath+erwise prvvided in tliis chapter. <br /> I certify that I have read and understand and will comply 'th the provisions af this asbestos notification <br /> statement and that I will comply with all state and federal egulatians pertaining to asbestos. <br /> ���.���� <br /> Licen e Contractor Signature Date <br /> � e �� t�a J� <br /> Lieense Holder(Contractor Printed Name License Number <br /> ���� J� �� � <br /> Address of Cpnstruction Site <br /> l � <br /> Pezmit Number <br />