HomeMy WebLinkAboutTermite Spray Planning &Development Services
Building &Code Regulation Division
-01 01 2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT JOB ADDRESS: .S!
BUILDER/CONTRACTOR: /,"/pn,sll�fl,41 e,,, de/,��+f
PEST CONTROL CONTRACTOR:
PEST CONTROL LICENSE #:_ P
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: /o,ovv Chemicals used: _ � �.:G
Percentage of solution: Total gallons used: 1.4 Cob
Date of Treatment: l o IP yl Time of Treatment:
Footing �b
- 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 tb /
Signature of Exterminator
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 w/ll fail and a re inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistant jobs/te 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/s issued to and another copy for the building permit files The Treatment
Certificate shall pro vide 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 comp/eted 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.
CLEMEI` TS
PEST&ENVIRONMENTAL SERVICES
NOTICE OF PREVENTIVE TREATMENT FOR TERMITES
(As required by FL Building Code 104.2.6)
TREATMENT INFORMATION
Address of Treatment:
Date&Time: Technician: .
Product Used
Chemical Used No.of Gallons %Concentration
Area Treated(Sq. Feet) Linear Feet Treated
Stage of Treatment(Horizontal,Vertical,Adjoining Slab, Retreat of Disturbed Area)
ADDITIONAL COMMENTS
AS PER 104.2.6.
If soil chemical barrier method for termite prevention is used,final exterior treatment shall be completed prior
to final building approval.
If this notice is for the initial soil treatment,initial and date here:
AUTHORIZED SIGNATURE
Clements Pest&Environmental Services T:(772) 562 6450
4036 43rd Avenue F:(772) 562 6457
Vero Beach,FL 32960 www.clementspestcontrol.com