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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 #: D-wo -o JOB ADDRESS: Lgw5 Lc�lcd g)vd
BUILDERJCONTRACTOR: 1 r4 I Choice- Coycre+c.
PEST CONTROL CONTRACTOR: -
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:. '�a�T Chemicals used:- )aI 5T
f ,
Percentage of solution: Total gallons used: G a0QnS
Date of Treatment: Time of Treatment:- �
`Footing - - - - - - - _,Slab -
1 Treatment ! _1st Treatment
Re-Treat Re-Treat -
Driveway Pools
1 Treatment 1t Treatment
Re-Treat Re-Treat
Other ' `" Perimeter for F 1 Inspection
1A Treatment
Re-Treat
Signature of.E6Wrminator. 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 inspectorlat time of each inspection or the scheduled inspection will fail and a re inspection
fee charged. : 4
FBC104.2.6 Certificate of Protective Treatment for prevention of termites.. A weather resistant jobsite posting board
shall be provided to receive dupiicafe Treatment Cen3ficates as each required protective treabnent-is completed,
providing a copy for the person'thi permit is issued to and another copy for the building permit files. The Treatment
Certificate shall provide the product bsed,identity of the"applicator,time and date of the treatment,site location,area
treated,chemical used,percent concentration and number ofgallonsused, to establish a verifiable record"of .
protective treatment. If the sot/the ica/"barrier method for termite prevention is used,final exterior treatrnentshall
be completed prior to final building a�proval.
St Lucie County requires for t e 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- --�
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