HomeMy WebLinkAboutTERMITE TREATMENT-RohanPlanning & Development Services
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 O1 Gr�--00-SJOB ADDRESS:
BUILDER/CONTRACTOR: 5ylst- V, /
PEST CONTROL CONTRACTOR: EVICT -A -BUG TERMITE & PEST CONTROL INC. -"�-` t e, r)---
PEST
1__
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: C l-1 17�_
Percentage of solution: .05% 1
Date of Treatment:
Footing
1St Treatment
Re -Treat
Driveway
1St Treatment
Re -Treat
Other
1St Treatment
Re -Treat
Chemicals used: DOMINION 2L
Total gallons used: [
Time of Treatment:
a
Slab
1St Treatment
Re -Treat
Pools
15t Treatment
rimet�ef for Final Inspection
Signatul� of
Note: There must be a completed form for each required treatment or
site to be picked up by the inspector at time of each inspection or the S
fee charged.
Date
lent and this form must be on the job
inspection will fail and a re -inspection
FBC 104.2.6 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 fifes. 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 termite 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
• Termite InspectionJesus Christ is 117 772-323-7921
• Termite Pretreatment Me A-809 T811 free :1-877 315-9990
• Pest Control Termite &feX: llZ-340-5990
• Rodent Service Pest
• Fire Ant Lawn Service Control, Email Evictabug@gmail.com
• Whitefly Treatment Inc. 4293 SW High Meadows Ave.
•Licensed & Insured Lic. 96175775 Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6, 105.10 & R318.1 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 TIME
DEVELOPMENT NAME (PROJECT)
CO
RACTOR'S NAME
CONTACT,PERSON
STRUCTURE ADDRESS (LOT/BLOCK)
CITY, STATE
COUNTY
NOTES
_
ZIP CODE
TREATMENT TYPE/AREA�—
%[~z�-/i
❑ FLOATING ❑ MONOLITHIC ❑ PATIO ❑ GARAGE ❑ DRIVEWAY ❑ STEM WALL/FOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TAMP & TREAT ❑ TREAT ONLY O FINAL ❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE U DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT O IMIDACLAPRID ❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑ .06% ❑ .1% L3.12% ❑ .25% ❑ .05% ❑ 23% ❑ 9% ❑ OTHER
SQUAREFOOTAGE
SQUARE FOOTAGE VERIFIED
l7 YES ❑ NO ❑ MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
O YES ❑ NO DETAILS
GALLONS APPLIED
LINEAR FOOTAGE
i°Certificate of Compliance"
As per 104.2.6, 105.10 & R318.1 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 laws 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
O ELECTRICAL PANEL ❑ WATER HEATER ❑ OTHER
Payment Terms: Payment due at time of service.
�,y�uuu�ttou,
Date Applicator: (EvictA Bug^lermite and Pest Control, Inc.)
r
Date Customer (Property Owner or Agent)
www.evictabugpestcontrol.com