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Planning Development Services
�< Building&Code Regulation Divisions
2300 Virginia Ave
Fort Pierce,FL 34882 >,
772-462-2172 Fax 772-462 6443 ;
�? CERTIFICATE OF TERMITE.TREATMENT �
'S CONSTRUCTION SOIL-TREATMENT
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PERmIT #:sr 7 �st'7c -- JOB ADDRESS: .S / '� �'�� y ham" r `/ L-,'� z1
BUILDER/CONTRACTOR: L c dimes 1
PEST CONTROL -0-.-
PEST CONTROL LICENSE #; f l d I
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We,tree undersigned,hereby certify that we have pretreated the above described construction for �?
z� subtenanean termites in accordance with the standards of the National Pest Control Association_
5 square feet if area treated: r Chemicals used:
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Percentage of solution: Total gallons used: /� s
Cate of Treatment
7 Time of Treatment: J`• ;z
f� Footing Slab ;
11t Treatment 1t Treatment s
Re-Treat Re-Treat ;?
Driveway -pools >
`< a Treatment 17t Treatment
Re-Treat 1 Re-Treat
Perimeter for Finn pe -,or, ;
-Le Treatment
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>,}> ignature of Exterminator pate s;
lvoh• There must•be a completed few far each mqulred tr wtwantorre-�atrrierrt arrd ifus form must be an the jo(� zs
site to be pided up by the lrispe uraf ame of each imMcbon orfftesdwduled inspection wllifall and a re-inspection
<< fee cfrarged•
FBC104.2.6 CeromteofPrtvtectfrreTreatmentforpreventionoftumilm A cvea1irerrestslantj0bsepasitnghoard
?? shall be provided to recefve duplitate Trw&4errt CerMCates as each reqcrired proteffM f W&MtIScprnpl tUd, <<
pravlding a 07pyfOrMe person the peimif fs lswed to and anather copy for the building permit iEw The 7iealment <'
y; Certificate shall provide the product'used,Identity ofthe applicaiar,time and date of Me treatment,As lorafion,a�a
ti'2aW dlemfw(useo;percent COncentrratran and number ofgallons used, to establish a verifiable record of s
pr9fvct ve treahnent Ifthe salt dy emiraf bam'ermedW for termJW preverrb'art fs used,final arierior freatmectshall
{s be completedpriar to IMI bu!ldng approval. }
1 St Lucie CounW requires for the final inspection for CO,a.Permanent Sticker to be placed on
S the elecWgcal panel box cover,Ust<'ng all the treatments and dates of applicationr-
Revised W202014 Z`
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