HomeMy WebLinkAboutTERMITE CERT Planning &Development Services
I J� - Building &Code Regulation Division
0 2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: &e�Y— JOB ADDRESS: 62 J(J,
BUILDER/CONTRACTOR: &-2,�/ .-
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: DOMINION 2L
Percentage of solution: .05 Total gallons used: 2-C/
Date of Treatment: 197!- O. Time of Treatment: r C)
-� Footing Slab -
1st Treatment 11t Treatment
Re-Treat Re-Treat
Driveway Pools
1st Treatment 1st Treatment
Re-Treat -- ''`` Re-Tr
Other C A-c�/-� S Perimeter foreat ns ection
1s Treatment
Re-Treat 4
Signatu erminator Date
Note: There must be a completed form for each re ired treatme or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection o the scheduled inspection will fail and a re-inspection
fee charged.
FBC 104.2.6 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 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 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 e505 Christ is doh 772-323-7921
• Termite Pretreatment. �® EVICt-A-Bug a TO frog. 1-811365-9990
• Pest Control M Termite & faX:7I2-349-5999
• Rodent Service
••Pest .
• Fire Ant Lawn Service - ,�� Control, Email: Evictabug@gmail.com
•.Whitefly Treatment lllc'i 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 II RcfO(/DENT EXCLUSION&REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE f I TIME �6 �` � �/ ' �'l 7 3VZJ
DEVELOPMENT NAME(PROJECT) CONTRACTOR'S NAME CONTACT PERSON ,/
'
r-5` 'l5 j �ad
STRUCTURE ADDRESS(LOT/BLOCK) Z +' , CITY,STATE COUNTY
NOTES( ZIP CODE
TREATMENT TYPE/AREA
❑FLOATING ❑MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM WALUFOOTERS ❑ADDITION
al`CUTOUTS ❑FOOTER ❑FRONT ENTRY ❑RETREAT ❑BORA CARE TREATMENT ElPLUMBING CUTOUTS ❑SIDEWALKS
❑TAMP&TREAT Ct]-'TREAT ONLY ❑FINAL ❑POOL DECK ❑OTHER
1
PRODUCTS
❑BASELINE �La DOMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE ❑PREMISE ❑TALSTAR
❑OTHER
ACTIVE INGREDIENT -. O\IDAi LAPRID=❑-BIFENTHRIN= EI DISODIUM OCTABORATE.TETRAHYDRATE- _
CONCENTRATION
❑.06% ❑.1% ❑.12% ❑.25% R.05% ❑23% ❑9% ❑OTHER GALLONS APPLIED 6�?62
SQUARE FOOTAGE ") LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
(Y;YES ❑NO tp MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
YES ❑NO DETAILS
V L°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.
�WUWmuiihni
Date pp/licator:(Evict Bug Termite d Pest Control,Inc.)
Date Customer(Propertt Owner or Agent)
www.evictabugpestcontrol.com
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