HomeMy WebLinkAboutTermite Treatment 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
1�f 311
51�1 P t�Y�r FC gS
PERMIT #. JOB ADDR SS.
BUILDER/CONTRACTOR: SL p
PEST CONTROL CONTRACTOR: EVICT-A-BUG TERMITE&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:. Chemicals used:
o`
Percentage of solution: Total gallons used:
Date of Treatment: `U` Time of Treatment:
Footing Slab
1st Treatment 1st Treatment
Re-Treat Re-Treat
Driveway Pools
1st Treatment ist Treatment
(� Re-Treat Cf�rPO�r� Re-Treat
Other 1 Perimeter
,for Final Inspectionn
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 '
• Termite Inspection Je5LJ5 Christ is �orq 772-323-7921
• Termite Pretreatment Me A-pug roll free: 1-577-315-9999
• Pest Control Termite & fBX: 11Y-340-5990
• Rodent Service Pest
• Fire Ant Lawn Service Control, Email: Evictabug@gmail.com
• Whitefly Treatment Inc. 4293 SW High Meadow Ave.
• Licensed & Insured Lic.JB175775 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 9!(1 0 If A��L / TIME U
DEVELOPMENT NAME(PROJECT) ks CONTRACTOR'S NARlv\t �QAz TCONTAITPERSON� 77 !�� �r �STRUCTURE ADDRESS(LOTIBLOCK) ' t% (/t l CITY,STATE COUNTY
l
NOTES 15 I L� ZIP CODE
TREATMENT TYPE/AREA
❑FLOATING ❑MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM WALLIFOOTERS ❑ADDITION
❑CUTOUTS ❑FOOTER ❑FRONT ENTRY ❑RETREAT ❑BORA CARE TREATMENT ❑PLUMBING CUTOUTS ❑SIDEWALKS
❑TAMP&TREAT t7 TI4EAT ONLY ❑FINAL ❑POOL DECK ❑10THER Of PU T
PRODUCTS
❑BASELINE 6,DOMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE ❑PREMISE ❑TALSTAR
❑OTHER
ACTIVE INGREDIENT -- - -"— -- - U-11MIDACLAPRID 0 BIFENTHRIN ❑DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑.06% ❑.1% ❑.12% El.25% 0,�:05% ❑23% ❑9% ❑OTHER GALLONS APPLIED )"
SQUARE FOOTAGE J z z(/ LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
O YE ❑NO O MEASURED OR VERIFIED PER PLANS
JOB
//READY CONDITIONS MET
OYES ❑NO DETAILS
"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
FINAL STICKER `
❑ELECTRICAL PANEL ❑WATER HEATER ❑OTHER ,•,
Payment Terms: Payment due at time of service.
s/ � �u}Ut11ll9�,Agrpry
C(l
I ,
Date Applicator:(Evict A Bug Termite and Pest Control,Inc.) ""
bs
Date Customer(Property Owner or Agent)
www.evictabugpestcontrol.com