HomeMy WebLinkAboutTermite Treatment Cert_Permit 2101-0639• Termite Inspection • e5�5 Christ is for 772-323-7921
• Termite Pretreatment EVICT -A -Bug tl Tell free.1-B77-305-9999
• Pest Control Termite &
• Rodent Service Pest feX:112-340-5990
• Fire Ant Lawn Service Control, Email: Evictabug@gmail.com
• Whitefly Treatment Inc. 4293 SW High Meadow Ave.
• Licensed & Insured Lic. JIB175775 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 WHITEFLY TREATMENT
DATE OF SERVICE TIME
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME CONTACT PERSON _
STRUCTURE ADDRESS LOT/BLOCK) CITY, STATE COUNTY
NOTES 1 ZIP CODE
U FLOATING
❑ MONOLITHIC ❑ PATIO
U GARAGE ❑ DRIVEWAY
❑ STEM WALUFOOTERS ❑ ADDITION
❑ CUTOUTS
UFOOTER ❑ FRONT ENTRY
❑ RETREAT ❑ BORA CARE TREATMENT
❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TAMP & TREAT
LfTREAT ONLY ❑ FINAL
❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE
U"DOMINION 2L ACTIVE INGREDIENT
❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE
❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT - ❑ IMIDACLAYRID ❑ BIFENTHRIN- ❑ DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑ .06% ❑ .1% ❑ A2% ❑ .25% LY.b5% ❑ 23% ❑ 9% ❑ OTHER GALLONS APPLIED
SQUARE FOOTAGE
LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
i
ONES ❑ NO 81MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
AYES ❑ NO
"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 (% \ () A
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER
Payment Terms: Payment due at time of service.
)
Date
Date
❑ OTHER
Applicator: (EvictA Buy Termite and Pest Control, Inc.)
i
Customer (Property Owner or Agent)
www.evictabugpestcontrol.com
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 #: ?101-
5. d(w Dr-
BUILDER/CONTRACTOR: (WA (0v61rtAC; o IA
PEST CONTROL CONTRACTOR: EVICT-A-BUGTERMIT&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: qSQ Chemicals used: DOMINION21-
Percentage of solution:.05%
Date of reatment: I D' `✓ 70
Footin
11t Treatment
Re -Treat
Driveway
is` Treatment
Re -Treat
Other
1't Treatment
Re -Treat
Total gallons used: M
Time of Treatment: 0
Slab /
✓✓✓ 1 t Treatment
Re -Treat
Pools
1't Treatment
Re -Treat
Perimeter for Final Inspection
Signature of Exterminator 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 Inspector at time of each inspection or the scheduled Inspection will fail and a re -inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistantjobsite posting board
Shall be provided to receive duplicate Treabment Certfficatm as each required protective treatment Is completed,
providing a copy for the person the permit is issued to and another copy for the building permit files. 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 ofga/lons used, to establish a ver/fiable record of
protective treabnent. If the soil chemical barrier method for termite prevention Is used, final exterior treatment shall
be completed prior to final bu//ding appro val.
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.
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