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Building &Code Regulation Division
2300 Virginia Ave
oil jwom;wl Fort Pierce, FL 34982
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CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: 0( __)JOB D ESS: �J rr
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR: EVICT-A-BLIGMAMITE&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: v2 t Chemicals used: DOMINION 2L
Percentage of solution: .05% Total gallons used:
Date of Treatment: Time of Treatment:
t-oo g
s reatment treatment
Re-Treat Re-Treat
_ Driveway Pools
1st Treatment 1st Treatment
Re-Treat Re-Treat
Other 4AL
erimeter for Fin ection ,
1st Treatment Re-Treat RAA..0191 byPAULCLUCAAAJR
2
(710.03.1913:3B:44-04W
ignature o rminator Date
Note: There must be a completed form for each requi d treatme t re-treatment and this form must be on the job
site to be picked up by the inspector at time of each in pection o t e 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 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 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
I the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014
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