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Planning) & Development Services
Building 8L Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CATION SOIL TREATMENT
CONSTRU
PERMIT it � -�
.JOB ADDRESS:
GUILDER/CONTRACTOR: �� '�� (,o
PEST CONTROL CONTRACTOR: Evl
PEST CONTROL LICENSE #: JB175775
-A-BUG TERMIT &PEST CONTROL INC.
We, the undersigned, hereby certify that we have pretreated the above described construction
subterranean termites in accordance with the standards of the National Pest Control Associatior
a re feet if area treated: ' �) Chemicals used: DOMINION K
i
Percentage of solution: .os°io
Date of Treatment:
Footing
1St Treatment
Re -Treat
Driveway
MLSt Treatment
Re -Treat
Other
.1st
Treatment
Re -Treat
Note: There must be a com leted form for each 1
P
site to be picked up by the inspector at time of e6
fee charged.
Total gallons used:
Time of Treatment:
Slab
ist Treatment
Re -Treat
Pools
15t Treatment
Re -Treat
Perimeter for Final Inspe
Signature of Exterminator
r
wired treatment or re -treatment and this form must eon the job
inspection or the scheduled inspection will fail and a e-inspectior,
F0C104,2p6 Certificate ofProtecfive Treatment for prevention of termites A weather resistanf jobsite p sting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment is com leted,
pro viding a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall pro vide the product used, identity of the applicator, time and date of the treatment, site i cation, area
treated, chemical used, percent concentration and number of gallons used, to establish a verifiable recor 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 pi ced on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014