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L(J LJ ) '- Building &Code Regulation Division
i�(� �, L 2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
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CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
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PERMIT #: I� q `C�� JOB ADDRESS: Co 4-K0
BUILDER/CONTRACTOR: >�ti
PEST CONTROL CONTRACTOR: JfS tAmrX-e, O
PEST CONTROL LICENSE 2
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: D Chemicals used:
Percentage of solution: -/® Total gallons used:
Date of Treatment: Time of Treatment: 10 0 Wnn
Footing !/`Slab
1st Treatment 1�Treatment
Re-Treat Re-Treat
Driveway Pools
1't Treatment 1't Treatment
Re-Treat Re-Treat
Other Perimeter for Fi9A Inspection
1't Treatment
Re-Treat
Si ature of Exterminator j
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Note: fbr_eactzrwwred treatment or re-treatment and this form must be on the job
site to be ^ —will fail and a re-inspection
fee chart Date_�ht�`
FBC104 - 1 antjobsite posting board
Inspection
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shall be, ° s � � ,o � � fitment is completed, !
providini Mit files The.Treatment
certificar 2FTreatrnent-_ amment,site.location, area
treated, rifiable record of
protectii (/_exterior trWtmentshal/
6 p� �be tomF772461m m —�______ ~`
St Luci Organism,lreated`. :erto be placed on!
the ele cations:
SUNRISE'PEST INC. esticide Use
2303 N. U.S. 1, STE., 11
FORT PIERCE, FL 34946 -
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