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RECEIVED "
r1, Planning &Development Services
Building&Code Regulation Division MAY 11 91021
o 2300-Virginia Ave `-
- Fort Pierce,FL 34982 Permitting department
St.Tude County
772-462-2172 Fax 772-462-6"3
CERTIFICATE-OF TERMITE TREATMENT
-CONSTRUCTION SOIL TREATMENT
PERMIT #: d O<?s`O JOB-ADDRESS: '331 'S6,9 /1V L? ' F7- lrn-e �G
BUILDERJCONTRACTOR: _ jWV5'
PEST CONTROL CONTRACTOR: COASTAL PEST CONTROL OF THE TREASURE COAST
PEST CONTROL LICENSE #: #8068/JB5594
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: f GIST
O
Percentage of solution: 0. 0 �� Total gallons used:.
Date of Treatment: ZZb o L_ -1 Time of Treatment: 4eS
Footing Slab
1st Treatment 4Treatment
Re-Treat Re-Treat
Driveway Pools '
1st Treatment 1st Treatment
Re-Treat Re-Treat
Other 'Perimeter for Final Inspecton
1st Treatment _
Re-Treat
Signatureof Exterminator Date
Note- There mustbe a completed form for each required treatment or re-freabnentand thls form mustbe 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 charger!.
FBC104.2.6 Certificate ofProtegc ive Treatmentforprevention oftermites A weab5erreslstantjobsite postingboard
shall be provided to receive duplicate,Treatment Certiflcates as earn required protective treatment 1s completed,
providing a copy for the person the permit Is issued to and another copyfor the building permitfiles. 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,.pallons used, to establish a verifiable record of
protective treatment: If the soil chemical barrier method for termite prevention is used,final exterior treatmentshall
K.
be completed prior to final building approval. h_.
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