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• Whitefl Treatment Inc.
Y 2373 SW Woodridge St.
Lic.JB175775 it
Licensed & Insured / 761 -03 7 � Port St. Lucie, FL 34653
Notice of Preventative Treatment for Termites
(as required by Florida Building Code(FBC)104.26 and Broward County Chapter FBC 105.2.2)
PEST PREVENTIO,N/ FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION&REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE `"7 Z // 7 TIME
DEVELOPMENT NAME(PROJECT) CONTRACTOR'S NAME CONTACT PERSON
STRUCTURE ADDRESS(LOTIBLOCK) �/' r y CITY,SATE,ZIP CODE . � COUNTY• �� /�'`(
-j
/
F V > \_
(TREATMENT TYPEIAREA I
❑FLOATING Q'MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM.WALLIFOOTERS ❑ADDITION
❑CUTOUTS ❑FOOTER ❑FRONT ENTRY ❑RETREAT ❑BORA CARE TREATMENT ❑PLUMBING CUT OUTS ❑SIDEWALKS
❑TAMP&TREAT �dTREAT ONLY ❑FINAL ❑POOL DECK ❑OTHER
PRODUCTS
O�BASELINE ❑DOMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE '❑PREMISE
❑OTHER
r: -
ACTIVE INGREDIENT— - - — - -- ❑-IMIDACLAPRib- iBIFENTHRIN 0 DISODIUM OCTABORATE TETR
��1 AH-YDRATE_.
7
CONCENTRATION
O^,.06% ❑.12% ❑.25% ❑.05% ❑23% ❑9% ❑OTHER GALLONS APPLIED
/SQUARE FOOTAGET�� �Q �� LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
b?YES ❑N0 �p MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET �-
�9YES ❑NO DETAILS
As per 104.2.6 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.)
i if this notice is for the final exterior treatment,initial and date this line
FINAL STICKER
❑ELECTRICAL PANEL ❑WATER HEATER ❑OTHER
Payment Terms: Payment due at time of service.
Date Applicator(Evict A Bug Termite and Pest Control,Inc.)
ate Customer(Property Owner or Agent)
i
t _ Planning &Development Services
Building &Code Regulation Division
® 2300!Virginia Ave
Fort Pierce, FL 34982
womw 772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: ?bl - 6 37,E JOB ADDRESS: L 5-1 Z Z u Po+e ��-
BUILDER/CONTRACTOR: R,c� ��/ * �11rAt\ ��
PEST CONTROL CONTRACTOR: EVICT-q 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: 9900 Chemicals used: BASELINE
Percentage of solution: .06% Total gallons used:
Date of Treatment z-h 2 Time of Treatment:
- Footing SI b
15t Treatment 1st Treatment
Re-Treat Re-Treat
Driveway Pools
11t Treatment 1st Treatment
Re-Treat Re-Treat
Other Perimeter for Finai Inspection
1st Treatment
Re-Treat �'
Signature of Fact rminator Date
Note: There must be a completed form for each required treatment or re-treatment and th/s form must be On the j'ob
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fall 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/s 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 appllcator, time and date of the treatment,site location, area
treated, chemical used,percent concentration and number of gallons used, to establish a vedflable 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
i
Planning &Development Services
. _.Ji _i Building &Code Regulation Division
2300 Virginia Ave
o Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: ��? b l ^U��I JOB ADDRESS:
BUILDER/CONTRACTOR: kkk Acn4` 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 Pe standards of the National Pest Control Association.
Square feet if area treated: Z0 � Chemicals used: DOMINION 2L
Percentage of solution: .05% Total gallons used:
Date of Treatment: Z) —1 Time of Treatment: g
Footing Slab
1st Treatment 1st Treatment
Re-Treat Re-Treat
Driveway Pools
1st Treatment 1st Treatment
Re-Treat Re-Treat
Other Perimeter for Final Ins ection
1st Treatment --
Re-Treat
Ignature of Extermiftakor Date
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 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
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014
RECEIVED SEP 2 6 7.017