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I <br /> � e 3�� ����c : o� �����.���,�s <br /> . _ , �Q .� <br /> ', �°`° "Ci.ty of Pure Water" <br /> � Building Department <br /> - 5335 E ghth Street•Zephyrhills,Florida 33542-4312 <br /> " �(8I3)�80-0020•Fax{813}78Q-OQ21 <br /> W.A.`Bilt"Burgess - <br /> Director of Building <br /> Licensing&Zoning <br /> Contra�tor Asbest s Notification Sta�ement <br /> Per�+'lorida Buildin�,Coti+e 105.9 Asbestos. The enforcin�a�encv shall requiz�e each buildin�nermit for <br /> the damolition ar renovation of an exisfiin�siruc�ure to contain an asbestas narificatian statement which <br /> indicates the owner's ar a eratar's res onsibili ' to com 1 with the rovisions of Section 469.003 <br /> i Florida Staiutes,and to notifv the Denartment f�nviranmental Protection of his or her intentions ta <br /> `� remove asbestos,when applic�ble,in accor+da�hce with st�te and feder�l Iaw. ; , <br /> 469.Q03 License Req�ired— <br /> ; 1. No person may condrzct an asbe tas survey,develop an operatian and maintenance plan, <br /> ar monitor and evaluate asbestos abatement unless trained aud liaensed as an asbestos <br /> � consultant as required by this ch�pter. <br /> i <br /> ', 2.(�� No person may prepare asbestos batement specifications unless trained and Iicensed as <br /> i an asbestos consultant as require by this chapter. <br /> � {b) Aszy person engaged in the busin ss of asbestos surveys prior to October 1, 1987,who <br /> has been certified by the Dep ent of Labor and Employmant Security as a certified <br /> � asbestas surveyor and who has c�mplied vvith 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 E�ployment Security may,by rule,establish violations, <br /> disciplinary procedures,and pen ties for certified asbestos surveyors. <br /> 3. No persan may conduct asbestos abatement work unless licensed by the deparbment � <br /> under this chapter as an asbestos lontractor,except as otherwise provided in this chapter. <br /> I cerhfy that I have read and understand a.nd wilI oamply with the proviszons of this asbestos notification <br /> statement and that I will comply with alI state and federal regeilations pertaining to asbestos. <br /> �vS C��Si�tU�.���� INC. �;t- �.- 28t �( <br /> Lieense HolderJContractor Signature Date <br /> I _ jus �.o�slRUc�� a�u �r�c, (�GC06,9y2. i <br /> �` License HalderlContractor Frinted Name License Number � <br /> I <br /> � S3'�7 $+'- S"C(tk E Z�.P N� R�11 LI.�S �l. 3354�. � <br /> � Address of Construction Site � <br /> � <br /> � <br /> � t5�a? � <br /> Fermit Number � <br /> � <br /> � <br /> � <br /> � � <br />