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-1 j 1:J j Building &Code Regulation Division
• 2300 Virginia Ave
• Fort Pierce,Fl.34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: i r70 00 ' JOB ADDRESS:
BUILDER/CONTRACTOR: 0/ (--"vv7S 1. FZ,)r� Pj ereA F-L -a ci e-1
PEST CONTROL CONTRACTOR: T-11& k3U63 br - Pe-S-1-- (bo-116T.—L,LC .-
PEST CONTROL LICENSE #: j.� 19-Lfe 40 9
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: Chemicals used: TA 4 P'r"�
Percentage of solution: Total gallons used:
Date of Treatment: Time of Treatment:
Footrng Stab
I't Treatment 1�Treatment
Re-Treat Re-Treat
Driveway --_Pools
j'Treatment 1'Treatment
"Re-Treat Re-Treat
—Other Perimeter for Final Inspection
V Treatment
Re-TreatS4=an—
�ignature of Exterminator bate
Mote" There must be a completed form for each required treatment or re-treatment and this form must be on thejob
site to be picked up by the inspector at bine of eadr inspection or the scheduled inspection will fail al7d a re-inspection
fee charged
FBC104.2.6 Cel-Mcahe of Protective Treatment for prevention of termites. AweaMerresh;tantjobsiteposting bwrd
shall be PrOvIded to receive duplicate Treatment Certificates as eaM required protective treatment is completed,
providing a copy for the person the permit is 15SUed tri and another copy for the building permit fifes The Treatment
Cezgficate shall provide the product used,identify of the applicator, time and date of the&aatmen4 site location,area
treated,Chemical used,percent concen&atibn and number of gallons used, to establish a verifiable record of
protective treatment If Me soil chemical barrier method for termite provention Is used,Mal exterior&wbnentshall
be completed prior to final building approval.
St Lucie County requires for the final inspection for CO,a Permanent Sticker to be placed on
the electrical panel box cover,listing all the treatments and dates of applications.
Revised 7/24/2014
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