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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 #: S LC - Zol z,- pgS18 JOB ADDRESS:
BUILDER/CONTRACTOR: 4-lcat 7M CON-1
PEST CONTROL CONTRACTOR: lPre Cryrr4r
3tlRq'r�' -
'100 N- aocg- J?-Oft . F7 t°tgcct�r
PEST CONTROL LICENSE #: 1$ ZL?SRO
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: 45Q 0
Percentage of solution: 1010
Date of Treatment:
Footing
1st Treatment
Re -Treat
Driveway
Is'Treatment
Re -Treat
Other
15t Treatment
Re -Treat
Chemicals used: ]?ON-i N 1 D Al ZL .
Total gallons used: 5'q 5-
Time of Treatment: Clr t 0 tt-1K ot-q-20Z 1
/Slab
vis'Treatment
Re -Treat
Pools
1-'3' Treatment
Re -Treat
Perimeter for Final Inspection
4y&� -S • q - L(- Za Z
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 resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protecrive treatment is completed,
pro viding 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 of gallons used, to establish a verifiable record 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 placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014