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Planning ®eve8opment Services
Building &Code Regulation Division
® 2300 ViirgI nia Aire
(Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443 I
CERTIFaCA E (OF TERMITE TREATMENT
C ONSTRUCTX®N SOIL TREATMENT
PERMIT #: ?d:3 OW-7 JOE ADDRESS: -2,&q ::rum I+cl
BUILDER/CONTRACTOR: C onr✓ne,�-cZ
PEST CONTROL CONTRACTOR: EVICT-A-BUG TERMITE&PEST CONTROL INC.
PEST CONTROL LICENSE #: JB175775
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:
J_�JChemicals used: BASELINE j
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Percentage of solution: •06% Total gallons used:
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Date of Treatment: ( � Time of Treatment:
Footing Slab j
1St Treatment 1St Treatment
Re-Treat Re-Treat
Driveway Pools
ist Treatment 1St Treatment j
R -Treat Re-Treat
ether_ �i �d Perimeter for F' I Inspection
1 Treatment
Re-Treat —f 7
Ignature of Facterminato Date
Note: There must be a completed form for each requlred treatment or re-treatment and th/s form must be on me job
site to be picked up by the inspector at time of each inspection or the scheduled inspection w!il fall and a re-Inspection
fee charged j
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IFOC104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment Is completed,
pro v/ding a copy for the person the permit is Issued to and another copy for the building permit files The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment,site location, area
treated, chemical used,percent concentration and number ofgallons used, to establish a vedriable record of
protective treatment if the soil chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
St Lucie County requires for the ff nall inspection for C01 a Permanent Stli ker to be placed on
the eiectricM panel box cover, iis$irng afl the treatments and dates of apoloca$ions.
Revised 7/24/2014
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