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Nov 2014 02:52p Magnum Demolifion 813-2603725 p.2 <br /> • a CITY Q ?�PHYRHr[�LS <br />( �� Flfii(gA n�.'Z Of .p�Z'@ WSt4°Z'rJ <br /> �v� <br /> Bui ding aepartment <br /> ' S33S Eighth S et�Zephyrhills,FZorida 33542�312 <br /> (813 7 0-0020 �Fax(8l3 780-0021 <br /> W.A."Biil"H�urgess <br /> Diractor of Building <br /> licensing&Zoning <br /> Contractor .�sbesfos N tification Statement <br /> Per Flarida Bailcl�n Code 105. Asbestos. Tlie enfo cin a shall nire each buildin ermit for � <br /> ti�e demolitiqn or renovation of an existin stcucttcre ta ontain an asbestos natificatian statement which <br /> indzcates the owner's or o ator's ansi`bili to ca I with the rovisions of Section 4�i9.003 <br /> Flozida Seafutes and to no tiie De rtment of En 'ronme�atal Prntectio�n of his or her intetttions ta <br /> rena.ove asbesta wheB a ticabie in aceord�nce wi state d federal]aw. <br /> 469.Q43 L3lcense Reqnired— <br />' 1. No peison may conduct aa asbestos ey,develog az�operation and maiu�enance plan, <br />�� or monitor and evatuate asbestas abate ent unless bra.ined and licensed as an asbestos <br /> eonsultant as requimd by this chapter. <br /> 2.(a) No person may pnepare asbestos aba ent specificarions unless trained and licensed as <br /> an asl�estos consultant as rec��ired hy 's chapter. <br /> (b) Any peraon engaged in the business o asbestos�xaveys priar to October 1, 1987,who <br /> 3�as baen certifie@ by the Deparirnent Labnr and Employment Security as a certified <br /> asbestas sxuve�ar and wbo izas compli d vviith the training requirements of S. <br /> 469.013(1)(b),maY provid�e survey se 'ces as descnbed in S.255.553(1},(2)and{3). <br /> `Fhe Depar�nent of Labor and Emplo ent Security may,by nile,es#ablish vio�ations, <br /> disciplinary praoedures,and penalties or+certified asbestas surveyors. <br /> 3. No person may conduct asbestos abat ent work uwless Iicensed by the departrnent <br /> under this chaptez as an asbestos contr ctor,exeept as otherwise provided in this chapier, <br /> I certify that I have read and understand and will camp y with the provisions of this asbestos notiScation <br /> staterue�t and that I wi[�camply with all state and ferl reg;alations pertaining to asbestos, <br /> a�a� ��"n?'Z� <br /> i e Hdlder/Co�ztraetor Signature Date <br /> �jAR�A i� �"��-�N � i Z 9 � <br /> License fiolder/Contractor Printed Narne Liceuse Nuznber <br /> 3�3 2 9 r s t�. �v�. �� �a�,���.s �� a3s�2- �s�s�r <br /> Address ofConstruefiion Site <br /> � � 5��� <br /> P�rnnit Number <br />