HomeMy WebLinkAboutCERT OF TERMITE TREATMENT.pdfPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
..:I Fort Pierce, FL 34982
_._ 772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: 2-011 --
JOB ADDRESS:
1'310
CPID I-n�2ave-ra.
BUILDER/CONTRACTOR:
Iilll-II&ES
&
S t -
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.
(, V1ka,r z4A
e feet if area treated: (SQQ/,1O ry Chemicals used: DOMINION 2L
Percentage of solution: .05%
Date of Treatment: c%
Footing
1st Treatment
Re -Treat
ADriv way
1st Treatment
Re -Treat
Other.
1st Treatment
Re -Treat
Total gallons used: t a-o
Time of Treatment: \";r0_6
Slab
1st Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspectio
t� a-
Signatuk 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 treatw&r7t 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
• Termite Pretreatment
• Pest Control
• Rodent Service /V
• Fire Ant Lawn Service
• Whitefly Treatment
5 c_nrlst is for 772-323-7921
[Viet A Bug a T011 PER' 1-577 365 9990
Termite & ME 772-340-5090
Pest
Control, Email: Evictabug@gmail.com
Inc.
• Licensed & Insured Lic. JB175775 4293 SW High Meadow Ave.
Notice of Preventative Treatment for Termites Palm City, FL 34990
(as regt.;tred by Florida Building Code (FBC) 104.2.6, 105.10 & R318.1 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE AN SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE TIME
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME
CONTACT PERSON
STRUCTURE ADDRESS (LOT/BLOCK)
CITY, STATE COUNTY
NOTES
I I ZIP CODE
TREATMENT TYPE/AREA
❑ FLOATING ❑MONOLITHIC ❑PATIO
O GARAGE ❑ DRIVEWAY ❑ STEM WALL/FOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUTOUTS ❑ SIDEWALKS
❑ TAMP & TREAT ❑ TREAT ONLY ❑ FINAL
❑ POOL DECK ❑OTHER
PRODUCTS
❑ BASELINE ❑ DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT CONCENTRATION ❑ IMIDACLAPRID -❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .06% ❑ .1% ❑ .12% ❑ .25% ❑ .05% ❑ 23% ❑ 9% ❑ OTHER
GALLONS APPLIED
SQUARE FOOTAGE
LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
❑ YES ❑ NO Q MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
❑ YES ❑ 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. ♦ }=
"� uuunur,
'�ti�AlTlijE 'o
Date
Applicator (Evict A Bug Termite and Pest Control, Inc.) " 4
st� �
l� P
Date Customer (Property Owner or Agent)
".,nn
www.evictabugpc