HomeMy WebLinkAboutTermite Certificate 0311512018 14:11 Wipeout Pest "" rmites "AX)M 429 3229 P.0021002
Planning &Development Services � !I
Buildin &Code Regulation Division
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9
r 2300 Virginia Ave
Fort Pierce,FL 34982
772-462-2172 Fax 772-462-6443
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CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: JOB ADDRESS: 55 p3 D-e-ce kuyi
BUILDER/CONTRACTOR: Sys'
PEST CONTROL CONTRACTOR: i e oi)-1-
PEST CONTROL LICENSE #: r 13 2G6 2 5
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.
LiV)
Wale feet if area treated: l a Chemicals used- ,
Percentage of solution: Total gallons used:
Date of Treatment: S Time of Treatment: 3W j?,t
Footing --,—Arab
1't Treatment _1t Treatment
Re-Treat Re-Treat
Driveway Pools
1'Treatment 1"Tr ent
Re-Treat R r t
Other Perim r f Fn Inspection
11 Treatment
Re-Treat
69ignatureof i or Date
Note: There must be a completed form for each required treatment r atment and this form must be on the job
site to be picked up by the inspector at time of each inspection or bh eduled inspection will fail and a re-inspection
fee charged.
FBC104.2.6 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,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall provide the pmduct used, identity of the applicator,time and date of the treaftent,site location,area
treated, chemical used,percent concentration and number of gallons used, to establish a venflable record of
protective treatment. If the soil chemical barrier method for termite prevention Is used, final exteiror treatment shall
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
03/1512018 14:10 Wipeout Pest °T-rmites +TAX)772 425 3229 P.0011002
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APPT•-ATE ^�J( ' '/ TIME
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lNSPEC70R TECH '`�' '' �o M 0 Z■, . / �< ,P`J
, ■.■. . r �� ��. . C DATE TAKEN: BY.
1111mal r Mama ■
tel ■ ■ � � r ■
Services, LLC
Martin 772-287-8486•St.Lucie 772.429-7716
Iodine River 772-567-7392 • Palm Beach 561746-7MA
Corporate Otfce
4001 Vtronia Avenue,Suit:A•Fbrt Picroe,Florida 3.1981
FOR FAST,PROFESSIONAL SERVICE CALL
CUSTOMER INFORMATION Acct. # 7� SERVICE REQUESTED 7
NAME nr. l , } /Lt/ 1
s.t
ADDRESS,y '""� ' ;Z" � a e'R,1 ,,III
Fliw
CITY STATE ZipCODEIGRID
CONTRACTS:
HOME PTEA r WORK TEL B
DIRECTIONS —_..
PAYMENT/CREDIT CARD INFORMAT ON AUTHORIZATION
=` -SVC AMT CARD TYPE /CHfiC /CARD N EXP BATE
AMT CODE DATE TIME
S �/�.� / -r Glc/C
3.
4,_
w D a
TOTAL DUE TOTAL AUTH. -DEFERRED DATE
CARDHOLDER NAME(If different from above)
I AGREE TO PAY ABOVE TOTALAMOUNT ACCORDING TO CARD ISSUER AGREEMENT(Visa/MastsrCard Customer Inquiries Gall 1.800-920-1079),
SIGNATURE: - DATE:
VALUED CUSTOMER COMMENTS:
SACES TECH COMMENTS:
I A / 7 ri
PEST CONTROL/FLEAS/OTS TERMITE/FUME
MATERIAL INSPECTED Evidence Treated MA'T'ERIAL
TREATMENT SITES TREATED Name(%)&Amt SITES (YIN) (Y/N) N�a�ria(96)&Artlourlt-
Mulch/Flowerbeds Foundation
Woodpile/Garbage Area Crawl Space ,% n
Doors/Windows/Eaves Interior Walls
Attic/crawl Space �/� / Door Frames
Underneath Appliances t - Window Frames
Wall Voids/False Bottoms l Batt,Traps
Cracks/Crevices i Attic /
Drawers/Cabinets/Closets % Other <-"7-'-, r"
Other
TARGET PESTS Tlme/8e9' - �+�CAn10:���/ / TOT:
Endorsem t hereon ackn led eeV. and satisfaction for services rendered. I certify lllwOo�ve°t0`be true an Wcurate re4ti)d-d1 my operations.
CV&T0MEn Ss<GxE ''
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