HomeMy WebLinkAboutCertificate of Termite Treatment _ Planning &Development Services
- Building &Code Regulation Division
• 2300 Virginia Ave
JL • R I D A Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #:_)-Ott-C' JOB ADDRESS:
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR:' 5ir kL(-.
PEST CONTROL LICENSE #:- -M Y745 k _
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: Chemicals used: 00(701101.1 l
Percentage of solution: Total gallons used:
Date of Treatment: Time of Treatment:
Footing _ Slab
�/ 1st Treatment 1st Treatment
y Re-Treat _Re-Treat
Driveway Pools
1st Treatment 1st Treatment
Re�Trjat Re-Treat
ther {]t7ryl��7 �[kC�� Perimeter for final Inspection
_1st Treatment �-
Re-Treat
Signature of Enter inator 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
• Termite Inspection
• Termite Pretreatment - BUS � 772-307-3442
• Pest Control ' ' Email: thebu assassinsllc mails
• Rodent Service ASSASS g @g om
• Fire Ant Lawn Service r;=o r ' 1913 SW Castinet Lane
• Whitefly Treatment Port St. Lucie, FL 34953
• Licensed & 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 ! // - f TIME
!]F�V£LaPMENT NAME(PROJECT) CONTRACTOR'S NAME CONTACT PERSON
STRUCTURE ADDRESS(LOT/BLOCK) CITY.STATE COUNTY
NOTES /"'� y ZIP CODE
TREATMENT TYPE)AREA
❑FLOATING ❑MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM WALUFOOTERS ❑ADDITION
❑CUTOUTS ❑FOOTER ❑FRONT ENTRY ❑RETREAT ❑BORA CARE TREATMENT ❑PLUMBING CUT OUTS ❑SIDEWALKS
❑TAMP&TREAT VTREAT ONLY ❑FINAL ❑POOL DECK
PRODUCTS
❑BASELINE OMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE ❑PREMISE ❑TALSTAR
❑OTHER
ACTIVE INGREDIENT Y MIDACLAPRID ❑BIFENTHRIN ❑DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION lJ��
LJ.M% 4.1% ❑.12% ❑.25% ❑.05% ❑23% ❑9% ❑OTHER GALLONS APPLIED_
SQUARE FOOTAGE LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
[1 YES ❑NO MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
YES ❑NO DETAILS
I
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 ❑OTHER
Payment Terms: Payment due at time of service.
Date Applicator:The Bug As.$.Jos.LLC
Date Customer(Property Owner or Agent)