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z planning&Development Services t:
Building&Code Regulation Division �
2300 Virginia Ave >
Fort Pleroe,Fl.34982
f772462-2172 Fax 772-462-644+3 �L
CERTIFICATE OF TERMITE.TREATMENT
CONSTRUCTION SOIL-TREATMENT
PERMIT#: 66 p-� �� �o DRESS:
BUIWER/CON 1 pAcr t: � rS
PEST CONTROL CONTRACTOR: `f F ,.�1`�c ( T �
PEST CONTROL LICENSE#: d
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T 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. �Z
l Square feet if area treated: Chemicals used:
N iT
` Percentage of solution: 6 Total gallons used: E) �<
Date of Treatment: 1 Time of Treatment: 260 �z
l
Footing Slab S%
_t_istTreatment i Treatment
,� Re-Treat Re-Treat S
1 nveway/ Pools s
Treatment 1"Treatment
3 Re-Treat Re-Treat '
Other e' eter for final 3
1t Treatment
Re-Treat l rT
Signature of Exterminator Date
35 '
Note. There mustbe a completed fart far eadr required baabnentorm-tieabnent and ffrfs fofm mustbe on Me job
slte to be picked up bythe irtspectorat time oferach inspection or the sd7edcded inspection wifffall and a re4wecffbn
fee d7arged
FOM04.2.6 G'ertftufeofAVI&C rveTreabnentfurprevendon oftermites A weaffrerreSstantj0b5&pasBngbeard
shall be provided to mceine duplIcate Treabnent Certificates as a3ch required prod we beafinentis cvmplaM4
g
pr W&Wa a7pyfortf7e person ffie pemzftfs issued to and another copytbrthe buff&ng permitfiies The 7mahneirt 1 Zz Cer'tlflcate shall provide the product used,identity of the applicator,time and date of6he freatmsr4 site A?mfton area
ftwied,dtemical aged,permtmncent alfon and number ofgallons ise,&estai711sf7 a verifiable record of y
probxffve hwhnent Ifthe sot/d7emfc3l banier•me&od forhwmav prevention Is used,tlnal exterior treatment'shaff z
be conWete dpfiorto final btfldipg appivvaI. 1�
%z St Lucie County requires for the final inspection fbr CO,a-Permanent Stocker to be placed on zj
the electrical panel box cover,listing all the treatmerris and dates of appfic aUon&
t Revised 712412014 y SS
,$ 5
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