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CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT~~ me, GJOB ADDRESS 1S'~2 ~,..J -8.~s'" ~{~
St Lucie County Inspections
2300 Virginia Avenue
Ft Pierce, FL 34982
(772) 462-2172
BUILDER .T~~t::
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PEST CONTROL CONTRACTOR \AI I fJ:;ðJu-r
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PEST CONTROL LICENSE #
We, the undersigned, hereby certify that we have pretreated the above-described construction for
subterranean terlDites in accordance with the standards of the National Pest Control Association.
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.sq RIAl (, feet of area treated: / :z S Chemicals used: 1~1t:M , o./l..
Percentage of solution:
~O,%
Total gallons used:
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Date of treatment:
~ ·/1,--0 1
Time of Treatment:
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Q Footing
CJ 1 st Treatment
ORe-treat
I:J Slab
I:J 1st Treatment
[J Re-treat
l:I Driveway
I:J 1st T.reatment
I:J Re-treat
o Pools
Q 1 st Treatment
LJ Re-treat
o Other
r:J 1st Treatment
Q Re-treat
. Perimeter for Pinal Inspection
FBC104.2.6 Certijicate of Protective Treatment/or prevention of termites.
A weather resistant jobsite posting board shall be provided to receive
duplicate Treatment Certificates as eacll required protective treatment is
contpleted, providing a copy for the person the permit is issued to and
another copy for tlte building permit files. The Treatment Certificate shall
provide the product used, idelttity of the applicator, time and date of the
treattnellt, site location, area treated, chemical used, percent concentration
and number of gallons used, to establish a verifiable record of protect~ve
treatment. If tile soil chelnical barrier method/or termite prevention is used,
final exterior treatment shall be completed prior to final building approval.
St Lucie County requires for the tinallnspectioD for CO, a Permanent
Sticker to be placed on the electrical panel box cover, ItSting all the
treatments and dates of applications.
NOTE.-
There must be a completed form for each required treatment 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 the scheduled inspection will
fail and a re-inspection fee charged.
Revued 6/13/02 dmg
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