HomeMy WebLinkAboutDOC072921-07292021110359.pdfPlanning & Development Services
Building & Code Regulation Division
2M Virginia Live
Fort Pier€e, FL 3-4902
772-462-2172 Fox 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRICTION SOIL TREATMENT
PERMIT .#: 760q 04 JOB ADDRESS, l l Uef& V l4a,l t/�'
BuiLDER/CONTRACTOR: I Wdw4v H4+I Eockk
PEST CONTROL CONTRACTOR: Evic=x-Rye fiFRMITE A C*NTROL wo,
PEST CONTROL LICENSE #: J6175T/5
We, ft undemVned, Hereby eer Y that we have pretreated the above dWbed €outru0m for
rubterranean termites in a=rdawe with the fitandard§ of the National pat Control Agwwtion.
fit if area treated; Ciiami0l5 weds L
Perwntw of 6olution, _ a 5(� _ Total gal3ons Uw
Date of Tr tts it � Z► Time of Tredments 1- 6
r hating flab
____1s` Tr�atme�t Treatment
—_ ue-Treate=Trot
ivCrayos4s
'/ 19 Trcatmcnt _� Treatment
---- Re -Treat �a C Treat
V ____PeHnu tw for Anal Inspection
2_1" Treatment
--Re-Treat
Signature of EiiterminaW Date
Note: 7heie mustbe a ovmpl d form for eaoh re9u{rad tr�bne€Korre#raatmantand this form mush t{ia job
slte to be plow up by the Inspeotorat11me ofeaoh /175pg{on or the scheduled Inspection will fall and a rQ-inspedion
fee oharged.
FBC104.2.6CertlficateofProtectiva7reatmentforprevena017oftermiWs Aweatherresi5tantj0bSltepowlyA rd
shall be provided to recelve dupllrate Treatment CZYtfiat as each requlred proteflve trP "Ontl5 camp/eted,
providing a Copy for the parson the permit Is issued to and anodtraw forbV bulldlnppetmlt Ble5, The Treatment
Cerddcate shallproNde the product usad Idenetyofthe applicator, time and date of the beatmsnt, sltelocatlon, area
treated, chemleel used, pementm1wt eNon and numberofgallons used, to a b#sh a ver ffft rerard of
protedi've treatment. If the s®/l ohemloa/barrlermetJ for termite pravenbon is u�d, dne/ s�trrlar bea(mentshal/
! completed pnor w final bu/lding approval,
St Line 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.
Rf+Wx17/24I2014