HomeMy WebLinkAboutCERTIFICATE OF TERMITE TREATMENT+ I u U UV '`'U�'1����NC
Planning & Development Services
Building & Code Regulation Division
2300 Wirginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
RECEI EV p
FEB 0-6 2018
�T, 6Msf� �Qunty, Permitting
CERTIFICATE OF TERMITE -TREATMENT
comb SOIL"TREATMENT
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PERMIT #:5 L C / 7/ D68 30B /AD RESS: 3s,1 JU-611+ 1 n 5"
BUILDER/CONTRACTOR:�i
PEST CONTROL CONACTOR:
PEST CONTROL LICENSE #:
We, the undersigned, hereby certify that we have pretreated the above described coristnrction for
subterranean termites in accordaneeWith the standards of the National Pest Control Association.
Square feet if area treated: 6 t o c-
Percentage of solution: R a 6
Date of Treatment:
Footing
1st Treatment
F , Re -Treat
V Drive�w�
1 Treatment
Re -Treat
Other
P Treatment
Re Treat
Chemicals used: (Vas4c AtCkPI C"s
Total gallons used: --76
Time oTif Teatment
`'ofSI b
a
�p Treatment
Re -Treat "
Pools
1 Treatment
Re -Treat
Perimeter for Final Inspection
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Signature of Exterminator Date
Mote: Mere mustbe a completed form foreadl requlred treabne&,orre-healmentand ffvs form mustbe on the job
site to beepided up by the Impadorattime ofeach inspection or the sdreduledinspecUbv wiIlfall anda re -Inspection
fee charged
PBC104r2.6 Certificate ofPmteWMe Tr eatmentforprevendon often es A weatherreaMntjabs& posting board
Mall be provided to reml a dupllcate Treatment Certificalrssas eadl rggd d pmtedive bmbnentis cvrnpleted,
providi'nga copyforthe pecan the permltrsIzued to and another aapyforthe bulfding parmitiiles: The Treahnent
Certificate shall provide the product used, identity of the applicator, time and date ofthe treatment; Me focatfon, area
treated, d�emlwl Wed, percentcvnc enhwfion and number ofgallons used, to estebilsh a verifiable record of
protectrve treatment ifthesdll diemimfbantermethodfortermite pmvenfion is used, final ear treatmentshal!
be completed prior to final &Ming approval.
St 1Lucle Country requires for the final inspection for CO, a" Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dams of applications.
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