HomeMy WebLinkAboutCertificate of Termite Treatment,
Planning & oevelopment Sesvices
Building & code R~ulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE Of TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: ifcod::!,-o to l L-) JOB ADDRESS: (b l b 0-ye H /p,; f3 Ju J
~~~DER/CONTRACTOR: ·:l \S:J. JV)eie, Cl?, Jsl o,::+,c',-.-,
CONTROL CONTRACTOR: EVICT-A-BUG TERMITE & ~ST CONTROL INC. ..::::.:..:.::.:..:..::_---------------------PEST CONTROL LICENSE#: Je115115
We, the undersigned h b . ct· 1i subt , ere Y certify that we have pretreated the above described constru ,on or
erranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: 1;;(gl \ Chemicals used: .!::o~o:.'.M~1N~1o~N~~::..L ______ _
Percentage of solution: .o5% ____;__;..;_____;.--. -J-
Date of ~ent:
~ting
Treatment
_Re-Treat
_Driveway
_1st Treatment
_Re-Treat _Other _________ _
_ 1st Treatment
_Re-Treat
Total gallons used: -7-t-t.OL--------
lime of Treatment: _.z~:~0~0
-------
.. _:__Slab
_1st Treatment
_Re-Treat
_Pools
_1st Treatment
_Re-Treat
e meter for Final In
Note: 777ere must be a completed form for each req~/11 tf:atmen or re-treatment and this form must be on the Job
site to be picked up by the inspector at time of each mspection or the scheduled inspection w/11 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 ts completed
providing a a,py tor tfte person tfte pe,mlt Is fs5Ued ID and another copy for the building permit Hies. The rreatmef1t
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 numbe~
0
°,: gallo_ns used, to es~abltsh a verifiable record of
protective treatment If the soil chem/cal barrier method termite prevention is used, final exterior treatment shall
be completed prior to final building approval. • ction for co . St Lucie County requires for the final inspe t t ' a Permanent Sticker to be placed
the electrical panel box cover, listing all !he rea ments and dates of applications. on
Revised 7/24/2014
IA.a
• Termite Inspection
• Termite Pretreatment .
• Pest Control
• Rodent Service
hrist is 7 72-323-7921
Tall free:,I-Bll-3B5-BBBB
lax: 112-341-IBBB
• Fire Ant Lawn Service
• Whitefly Treatment
.,!-..Licensed & Insured Lie. JB175TT5
Notice of Preventative Treatment for Termites
Email: Evictabug@gmail.com
4293 SW High Meadows Ave .
Palm City, FL 34990
(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 ,..£.I RE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFL y TREATMENT
D~TE OF SERVICE C11 , I ) . ft O TIME z : 's C7
D~rLOPMENT NAME (PROJECT)
(} l_O 5 -'S-V IP --r\J\;,
STRUCTURE ADDRESS (L6 T/BLOCK)
I CONTRACTOR'S M'-1 E
1 I ~'-4 ,,, f-
CITY.STATE ...of{IP S /7~! I l
,NOTES
tREATMENTTYPEIAREA
FLOATING MONOLITHIC STEM WALUFOOTERS
tlitfOOTER FRONT ENTRY BORA CARE lREATMENT PLUMBING CUT OUTS
TAMP & TREAT ~TREATONLY FINAL
PRODUCTS
BASELINE ~MINION 2LACTIVE INGREDIENT TERMIDOR SC
OTHER _______ _
ACTIVE INGREDIENT-------------~lllAq.APR ID _ O BIFENTHRIN DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
25% a.OS% 23% 9% ____ _
o.oo% 0 .1% 0 .12% . V'
SQUAREFOOTAGE _~~nw~~~\~,----------LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
:gyES ONO 'fl -
JOB READY CO NDmO NS MET
/
GALLONS APPLIED g (} 't{ ~--
\:l NO DETAILS . A. YES "Certificate of Compliance"
If oil chemical barrier method for tennite prevention is used.
As per 104.2.6, 105.10 & R318.1 FBC .I t~ prior to final building approval.
• tre tment shall be comp e t fo the Final extenor a eel a complete trtatmen r PIIVentlon of subtemnean tennites Treatment
rfficate of Compl iance: The b~ildlng has rec:::. Agricutture and consumer Services. (Per the Florida Building Code:) Is In accordance with rules
I II hed by the Flonda Departmen
and laws estab s nt, Initial and date this line ---,r -----
otice Is for the final exterior treatme If this n
WATER HEATER
cTRICAl PANEL . Elf yment due at time of service -.
Pa
THER ~---?--;;;y----------/f!~~
-7"', r: , --~
~-ica..::=..-~-<--. l!ol;,~lnc.~)---------
°"' cusmmer ( b j " . -•~"' WWw . '•11;~'"""'"""' .ev1ctabug pes tco nt ro1 .i:x:,111