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Home My WebLink AboutCERTIFICATE OF TERMITE TREATMENT Planning &Development Services Building &Code Regulation Division 2300 Virginia Ave KANNIESIMMFort Pierce, FL 34982 772-462-2172 Fax 772-462-6443 CERTIFICATE OF TERMITE TREATMENT CONSTRUCTION SOIL TREATMENT PERMIT #: SLG " 'Zo% -,02-1"JOB ADDRESS: it `�14-" BUILDER/CONTRACTOR: <-IL41�_ PEST CONTROL CONTRACTOR: k\,JVA-k �- PEST CONTROL LICENSE #: 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: r ,VFU n Percentage of solution: Total gallons used (0 9"/[°, S Date of Treatment: S ' n- Time of Treatment: Footing Slab 1st Treatment 1st Treatment Re-Treat Re-Treat Driveway Pools 1st Treatment 1st Treatment Re-Treat Re-Treat Other Perimeter for Final Inspection 1st Treatment Re-Treat 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 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 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 J,Pry . Construction �YeravirPl liYaental 7-, ; T ermllte -Trj . a, " t : , e � -' ! 7670*0kedch6b e O W& A ett Palm.Zeadh,.T 1. .3- 34 11 Pholdi 1-600 285 37 . � Fax; - 56178 -022 4 Property 1nfgrna !qw Tr6a6efiiDate. BIOck " kai ieof Budder S6division N .91ioilcontiactot Stn-6tAddi6ss-(If k6o.k ) Construction Type elty Stat6 ZV .,... ' -' .r ' c : i M Of oi j` lC. OV 16 ' 4 fi ng/St-'er.' nwa--l-_l' , _ M :.-. ir ti0 ' Entry MDrive ay0Oth&:. ,Owner NameProdudt/Trea menf ln& matibn Treatment e: unuersiab PatioYDriyeway/Eny Finalyp Bait Systom Obih'r D Wood Treatment O Pkoduct ❑Digo odium CYPetnethrin pri ❑Bifenthrn P imethrn. ConcentrationMixed,'Product Applied Square FeefTfeated LinearFeetTreated• ]fthisbox 'i&C ;ekod, then R`iHal Pdtipbtet treatm nt. as baen"completed-and the 1611 Wi ngstatem n tis: PPIIGab'l,e Certificate'OfiConpliarce This-buildng hag rec&iyed-.4 66nplot6 &atment fort e preventi on,o subteftanean'termites.. hisIreatmont. is in accoiddice.withthe.!aws and rules established by the.- T16ridaDePdrtm6nt of AiricuIture and Corstimer,Services. 7 kp p ipatqr'§-Nam e (please print) Ap I at or"s Signature !IES-TE019 08/16." 1lulett Environmental Services©2016.