HomeMy WebLinkAboutTermitePlanning & Development Services
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 # :_ ;hg 10 - c)C)) q JOB ADDRESS: bez:t�?c ocLncd
BUILDER/CONTRACTOR:
PEST CONTROL CONTRA(
PEST CONTROL LICENSE
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: 'I "'I
c
Percentage of solution: Cl
Date of Treatment: 1
Footing
15C Treatment
Re -Treat
Driveway
15t Treatment
Re -Treat
Other
1st Treatment
Re -Treat
Chemicals used: .0 ,� C
Total gallons used: _ D,S U
Time of Treatment: ;
)<_Slab
_1st Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
Signature of Ua►'minator 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 comp/eted,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate 517allprovide 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 appro val.
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
• Termite Inspection
• Termite Pretreatment
• Pest Control
• Rodent Service
• Fire Ant Lawn Service
• Whitefly Treatment
• L'
772-307-3442
Email: thebugassassinsllc@gmail.com
1913 SW Castinet Lane
Port St Lucie FL 34953
lcensed & Insured Lic. JB 274536 '
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE
TIME r : • ' ,
—
utvtLUPMENTNAME (PROJECT)
STRUCTURE ADDRESS (LOTIBLOCK)
NOTES i
TREATMENT TYPEJAREA
❑ FLOATING Ll MONOLITHIC
❑ CUTOUTS ❑ FOOTER
UJAMP & TREAT ❑ TREAT ONLY
CONTRACTOR'S NAME
-i " )
L
CONTACT PERSON
CITY, STATE
❑ PATIO ❑ GARAGE ❑ DRIVEWAY
❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT
❑ FINAL ❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE 17 DOMINION 2LACTIVE INGREDIENT
0 OTHER
ACTIVE INGREDIENT
COUNTY
ZIP CODE
❑ STEM WALL/FOOTERS ❑ ADDITION
❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
IMIDACLAPRID ❑ BIrEN"THRiN CONCENTRATION ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .06% ❑ .12% ❑ .25% ❑ .05% ❑ 23% ❑ 9% ❑ OTHER
SQUARE FOOTAGE j— GALLONS APPLIED
LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
C� YES ❑ NO p MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
DYES LJ NO
J 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.)
If this notice is for the final exterior treatment, initial and date this line
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER
PaymentTerms: Payment due at time of service.
❑ OTHER
Date - Y
Applicator: The Bug Assas ins, LLC
Date
Customer (Property Owner or Agent)