HomeMy WebLinkAboutCertificate of Termite Treatment—`" Planning & 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 #: 1('0-1-0')5% JOB ADDRESS:-Za-igio C"-f 'R,3te
BUILDER/CONTRACTOR:
Pe c� �ut� �� S F If 3li� �/
PEST CONTROL CONTRACTOR: EVICT -A -BUG TERMIT & 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: C)Ir Chemicals used: DOMINION 2L
Percentage of solution: •05%
Total gallons used:
Date of Treatment: ) ' � - �1
Time of Treatment:
Footing
Slab
I" Treatment
1't Treatment
Re -Treat
Re -Treat
Driveway
Pools
1st Treatment
St reatm nt
Re -Treat
rest
Other
i�t Treatment
P rimeter for Final I pection
Re -Treat
nature of inator Date
Note; There must be a completed form for each required treatment re -treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection
fee charged.
or the scheduled inspection w111 fall and a re-Inspecdon
FBC104.2.6Cert/ficateofProtect/veTreatment forprevenbonoftermites. Aweather resistantjobsitepostingboard
shall be provided to rece/ve duplicate Treabnent Certificates as each required protective treatment is rnmp/eted, provld/ng a copy for the person the permit Is Issued to and another copy for the bW/d/ng permit fl/es The Treatment
certificate shall provide the product used, Identity of the applicator, time and date of the treatment, site location, area
treated, Chem/cal used, percent concentration and number ofgallons used, to establ/sh a verifiable record of
protect ve treatment. If the soil chemical barner method for term/te prevention /s used, final exterior treatment shall
be completed pr/or to final bu//ding 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
5 Christ is LOrtl
772-323-7921
• Termite Pretreatment
Je5
® fflet-A-Bug
Toll PRO.1-177-205.9899
• Pest Control
• Rodent Service
Termite &
Pest
FBI: 772449-5990
• Fire Ant Lawn Service
Control,
Email: Evictabug@gmail.com
• Whitefly Treatment
Inc'
4293 SW High Meadows Ave.
• Licensed & Insured
Lic. JB175775
Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6, 105.10 & R318.1 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION REMOVAL I WHITEFLYTTREATMENT
DATE OF SERVICE
TIME
(&
// N — 99
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME CONTACT PERSON
STRUCTURE ADDRESS (LOT/BLOCK) CITY, STATE COUNTY
NOTES ZIP CODE
❑ FLOATING
❑ MONOLITHIC
❑ PATIO
❑ GARAGE ❑ DRIVEWAY ❑ STEM WAUJFOOTERS ❑ADDITION
❑ CUTOUTS
❑ FOOTER
❑ FRONT ENTRY
❑ RETREAT 0 BORA CARE TREATMENT ❑ PLUMBING CUTOUTS 0 SIDEWALKS
❑ TAMP & TREAT
_Q TREAT ONLY
0 FINAL
❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE
❑ DOMINION 2LACTIVE
INGREDIENT
❑ TERMIDOR SC ❑ 80RACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
_ ❑ IMIDACLAPRID 0 BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑ .06% ❑ .1 %
❑ .12% ❑ .25%
0.05% ❑ 23%
❑ 9% ❑ OTHER GALLONS APPLIED
SQUARE FOOTAGE
LINEAR FOOTAGE 1.
SQUARE FOOTAGE VERIFIED
❑ YES ❑ NO .❑:MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
❑ YES ❑ NO DETAILS
"Certificate of Compliance"
As per 104.2.6,105.10 & R318.1 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 __.. — 1
FINAL STICKER
Q ELECTRICAL PANEL 0 WATER HEATER ❑ OTHER
Payment Terms, Payment due at time of service.
Date
Applicator: (EvictA Bug Termite and Pest Control, Inc.)
Uate Customer (Property Owner or Agent)
www. evictabug pestoontrol.com