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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 #: 0� JOB ADDRESS: Dt�
BUILDER/CONTRACTOR: ai>�
PEST CONTROL CONTRACTOR: EVICT-A-BUG TERMITE&PEST CONTROL INC.
PEST CONTROL LICENSE #: JB175775
We, the undersigned, hereby certify that we have pretreated the agove described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: 2M6_ Chemicals used:
Percentage of solution: •06% o e'59 Total gallons used: ,`
Date of Treatment: Time of Treatment: f�
—._ Footing - - - — — — -Slab— — — —
1st Treatment 1St Treatment
Re-Treat Re-Treat
Driveway Pools
i 1St Treatment St
Re-Treat Re- ea
Other Perimete for nal Ins n
1St Treatment
Re-Treat PAUL LUGAPA "'D"R" %
Date: 0 e 17 0�1:20 a"''^^'Qmt t ee w�
Signature f ermina Date
Note. There must be a completed form for each required treatme or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or he scheduled inspection will fail and a re inspection
fee charged.
i
FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weatherresistant 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 product used,identity of the applicator, time and date of the treatment,site location,area
treated, chemical used,percent concentration and number of gallons used, to establish a verifiable record of
protective treatment. If the soil chemical barrier method for tennite prevention is used, final exterior 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
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-� .__ Christ is - 772-323-7921
-ermite Inspection )esus lora
Termite Pretreatment EVICt A.8ug T011 free: 1-877-385-9999
• Pest Control
Rodent Service Termite & ME 772-340-5990
•
• Fire Ant Lawn Service Control, Email: Evictabug@g,maii.com
• Whi,tefly Treatment Inc. 4293 SW High Meadows Ave.
R;Licensed & Insured Lic.J6175775
Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code(FBC) 104.2,6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION&REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE " C C TIME
DEVELOPMENT NAME(PROJECT) CONTRACTOR'S NAME CONTACT PERSON
:!5AIJI-V O�J'AAnnl.,'14, �1 � ����► - ��� �33�-33U_�
STRUCTURE ADDRESS(LOT/BLOCK) 2 CITY;STATE+ 1 COUNTY
NOTES! ZIP CODE
TREATMENT TYPE/AREA
❑FLOATING ❑MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM WALUFOOTERS ❑ADDITION
❑CUTOUTS ❑FOOTER ❑FRONT ENTRY ❑RETREAT ❑BORA CARE TREATMENT ❑PLUMBING CUTOUTS ❑SIDEWALKS
❑TAMP&TREAT �PT$EAT ONLY O:FINAL ❑POOL DECK ❑OTHER
PRODUCTS
❑BASELINE UDOMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE ❑PREMISE ❑TALSTAR
❑OTHER
ACTIVE INGREDIENT — t7•IMIDACLAPRID ❑BIFENTHRIN -❑-DISODIUM OCTABORATE TETRAHYDRATE�
CONCENTRATION
E1.06% ❑.1% ❑.12% ❑.25% C3.05% ❑23% ❑9% ❑OTHER GALLONS APPLIED
SQUARE FOOTAGE LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
11<ES LINO �E7�i1EASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
O 'E5 ❑NO DETAILS
As per 104.2.6 FBC-If soil chemical barrier method for termite prevention is used.Final exterior treatment shall be completed prior to final building approval.
Certificate of Compliance:The building has received a complete treatment for the prevention of subterranean termites.Treatment is in accordance with rules
and lawsi established by the Florida Department of Agriculture and Consumer Services.(Per the Florida Building Code.)
If this notice is for the final exterior treatment,initial and date this line
FINAL STICKER
❑ELECTRICAL PANEL ❑WATER HEATER &OTHER
Payment Terms: Payment due at time of service.
Date Ap�tor:(Evict A Bug a time and Pest Control,Inc.)
Date Customer(Property Over or Agent)
/ t,till Iltl'%'
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