HomeMy WebLinkAboutTermite Cert• Termite Inspection 2`'05 Christ is �772-3237921
:Termite Pretreatment [Vic i -x-869 Tri!l free: 1-877-385-9599
Pest Control Termite & fax: 772.34D-5998
• Rodent Service 'Pest
Cor, ! Email: nmail.com
• Fire Ant lawn Service fr Evictabug@gmail.com
Whiteily Treatment 4293 SUV High Meadows Ave.
• Licensed & Insured Lic. JB175775 Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6, 105.10 8 8318.1 and Broward (County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE 1 TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE
TIME
DEVELOPMENT NAME (PROJECT) CONTRACTOR'SPAME CONTACT PERSON 7 �-
STRUCTURE ADDRESS (LOTfBLOCK) CITY, STATE COUNTY
NOTES
ZIP CODE
TREATMENT TYPEIAR
❑ FLOATING ® MONOLITHIC ❑ PATIO ❑ GARAGE U DRIVEWAY ❑ STEM WALUFOOTERS Q ADDITION
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS Q SIDEWALKS
L3 TAMP & TREAT ❑ TREAT ONLY ❑ FINAL ❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE ❑ DOMINION 2L ACTIVE INGREDIENT ❑ TERMIDOR SC Q BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
Q IMIDACLAPRID ❑ f3[FENTHRIN ❑ DISODIUM OCTABORATE TETRAHYOiZATE
CONCENTRATION
❑ .06% Q .1% Q .12%r ❑ :25% ❑ .05°ro' Q 23% LI9% Q OTHER
-
S DARE FOOTAGE LINEAR FOOTAGE
GALLONS APPLIED
R
SQUARE FOOTAGE VERIFIED
Q YES ❑ NO <] MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
❑ YES ❑ NO DETAILS
' "Certificate of Compliance"
As per 104.2.6, 105.10 & R318.l 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
l 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 t #
❑ ELECTRICAL PANEL ❑ WATER HEATER ❑ OTHER ;
— i► .r
Pavment Terms: Payment due at lime of service.
Dale Applicator: (Evict A Bug Termite and Pest Control, Ir1C.)• E
Data F Customer (Property Owner or Agenl) 4jA[ q�p0+y�
11rw u'
www.eviciabugpesteontrol.com
Planning & Development Services
�.r 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 #: ?V 0S ^ b(F, jj? JOB AAPDRE5S: 0-00-24
BUILDER/CONTRACTOR: l \e
PEST CONTROL CONTRACTOR: EVICT -A -BUG TERMITE & PEST CONTROL INC.
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: S S !R 5
Percentage of solution: .05%
Date of Treatment: %O o
_Footing
1' Treatment
Re -Treat
Driveway
1s'Treatment
Re -Treat
Other
11 Treatment
Re -Treat
Chemicals used: DOMINION 21 -
Total gallons used: "tom
Time of Treatment: !C) L
Slab
�'`I" Treatment
Re -Treat
Pools
1't Treatment
Re -Treat
Perimeter f r F' Inspection
PA� GA� � 1y9 13 L6L C L A,R 7 6 20
Signature of Exterminator Dat
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:
FBC104.2.6 Certificate of Protective Treatment for prevention of termites, A weather resistant jobsite posting board
shall be provided to receive duplicate Treatinent Certificates as each required protective treatment is completed,
providing a copy for the person the permit is issued to and another copy for the'budding permit files. The Treatment
Certificate shall pro vide 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 soll 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.
Kevised 712412014