HomeMy WebLinkAboutPICTURE - CERTIFICATE OF TERMITE TREATMENT & PREVENTIONpe f r,\',
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 #:2_0tZ.-0 (-b G JOB DDRESS: l�Q7 S I(� 'A) rjw or,
BUILDER/CONTRACTOR: G(/i P01 CUlrt ruc(
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 PNM
CContrControlAssociation.
Square feet if area treated: 4qU 6 Chemicals used: to (U 0 ?G
Percentage of solution: ° vJ 0 Total gallons used: YLO- _
Date of Treatment: v 106 I
Footi n
1st Treatment
Re -Treat
Driveway
1st Treatment
Re -Treat
Other
1st Treatment
Re -Treat
Time of Treatment:
STab�
is` Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
�a_ Zwnn_ XMIXIIA011
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 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
3eo�2
• Termite Inspection - Je5,,5 Christ is �orq 772-323-792'1
• Termite Pretreatment et-A-BUQ T011 frog.1-877 305-0990
• Pest Control f Termite & 181C 772-340-5098
• Rodent Service Pest
• Fire Ant Lawn Service Control, Email: Evictabug@gmail.com
, "
• Whitefly Treatment 4293 SW High Meadow Ave.
• Licensed & Insured Lic. JB175775 Inc. 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 -.
f` r h ( s`
STRUCTURE ADDRESS (LOT/BLOCK) CITY, STATE COUNTY
NOTES ZIP CODE
TREATMENT TYPE/AREA
❑ FLOATING ❑ MONOLITHIC ❑ PATIO ❑ GARAGE
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT
❑ TAMP & TREAT ❑TREAT ONLY ❑ FINAL ❑ POOL DECK
PRODUCTS
❑ DRIVEWAY ❑ STEM WALUFOOTERS ❑ ADDITION
❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ OTHER
❑ BASELINE ❑ DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT _ ❑iMIDACLAPRID—❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑ .06% ❑ .1% ❑ .12% ❑ .25% ❑ .05% ❑ 23% ❑ 9% ❑ OTHER GALLONSAPPLIED
SQUARE FOOTAGE LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
YES ❑ NO ❑`MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
El YES ❑ NO DETAILS
i°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.
Date Applicator: (Evict A Bug Termite and Pest Control, Inc.)
30. sk
Date Customer (Property Owner or Agent)
www.evictabugpestcontrol.com