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i - 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 #:-A 4ADDRJES
BUILDER/CONTRACTOR.
PEST CONTROL CONTRACTOR: 4 1 Ile
PEST CONTROL LICENSE #: 0 0
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: A_&_ Chemicals used: ( I Ir�� 'i �iw.�? e � ,. (,%_-C, �.._
Percentage of solution: i
Date of Treatment: .2
Footing
5'Treatment
-Re-Treat
Driveway
1" Treatment
Re -Treat
other
is'Treatment
Re -Treat
Total gallons used;
Time of Treatment: Gf A, 6'f'7
1" Treatment
Re -Treat
Pools
1't Treatment
Re -Treat
meter for Final I spection
�- 7
Si re of Exterminator pate
Note: There must be a completed forma for ea& squired treatment or re -treatment and this form must be on the job
site to be picked up by the inspector at tame of ea& inspection or the scheduled inspection will fail and a re -Inspection
fee caliayed.
FBCIO4.2.6 Cefbrflcaie ofProtertive Tfeatment for prevention of termites: A weather resistant " bsite
shall be .lo P�n9 board
provided to receive duplicate Treatment Certificates as each required protective treatment rs completed,
providing a copy for the perm the permit is issuer/ to and another copy for the building permit files. The Treatment
Certilrcate shall provide floe 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
PrrOtective treatment. If the sail daermical bawler 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, listiing all the treatments and dates of applications.
Revised 7/24/2014