HomeMy WebLinkAboutCERTIFICATE OF TERMITE TREATMENT 11-30-11z SCANNED
By
Planning & Devi
`= 5 Building & Code I
2300 Vir
- Fort Pierc
772-462-2172 F
CERTIFICATE OF T
.CONSTRUCTION
PERMIT #: � - a3_5_'7 JOB ADDR
BUILDER/CONTRACTOR: , OdZ I, P
PEST CONTROL CONTRACTOR: EVICT -A -BUG
PEST CONTROL LICENSE #: ,JB175775
ipment Services
gulation Division
nia Ave
FL' 34982
c 772-462-6443
RECEIVED
NOV
per
/nittyn 20/8
St 4Uc Coy;1?7ent
IP
IITE TREATMENT
L TREATMENT
ITE & PEST CONTROL INC.
i
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: 37 Chemicals used: DOMINION 2L
Percentage of solution: .os°i° Total gallons used: - ` (o
Date of Treatment:_L4/s / x
Footing
_ 1' Treatment
Re -Treat
Driveway
1st
Time; of Treatment: 1: G` �
A__islab
1' Treatment
Re -Treat
Pools
Treatment 1' Treatment
Re -Treat Re -Treat
Other I�Perimeter for Final Inspection
1' Treatment
Re -Treat
4igatfure �of Exterminator Date
Note: There must be a completed form for each req ' ed 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 resistant jobsite posting board
shall be provided to receive duplicate Treatment Cert/ficates 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 ofga)lons 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 bul/ding 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 RECEIVED g5�5 Ci,rlSt;*S 61' 72-323-7921
• Termite Pretreatment Nov 0 201e� EVICtA-Bug a d' T011 free:1-811365-9990
• Pest Control �
• Rodent Service . P®r�t�u�le cou ent ,Termite & fBX: 7I2-340-5990
Pest
• Fire Ant Lawn Service Control, Email: Evictabug@gmail.com
• Whitefly Treatment Inch 4293 SW High Meadows Ave.
• Licensed & Insured Lic. JB175775 Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 1041.6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE % / O TIME
DEVEWPME T NAME (PROJECT) CONTR TOR'S NAME: CO TACT PERSON
�tr � ate (do
STRUCTURE ADDRESS (LOT/BLOCK) , _ CITY, STATE COUNTY
NOTES
#r
i 112
G�S�
TREATMENT TYPEIAREA
❑ FLOATING
EI;MONOLITHIC
❑ PATIO
❑ GARAGE
❑ CUTOUTS
EI FOOTER
❑ FRONT ENTRY ❑ RETREAT
] TAMP & TREAT
❑ TREAT ONLY
❑ FINAL
❑ POOL DECK
PRODUCTS
❑ BASELINE
KDOMINION 2LACTIVE INGREDIENT
❑ TERMIDOR SC ❑ BC
❑ OTHER
ACTIVE INGREDIENT
IMIDAC
v
CONCENTRATION
❑ .06% ❑ .1 %
❑ .12% ❑k-25%
b .05% ❑ 23%
❑ 9% ❑ OTHER
q 4
SQUARE FOOTAGE
. S--7
SQUARE FOOTAGE VERIFIED
0 YES ❑.NO
JOB READY CONDITIONS MET
4 YES. ❑ NO
1
,A MEASURED OR
DETAILS
ZIP CODE
3 15�7
❑ DRIVEWAY ❑ STEM WALLIFOOTERS ❑ ADDITION
❑ BORA CARE TREATMENT ❑ PLUMBING CUTOUTS ❑ SIDEWALKS
❑ OTHER
❑ PREMISE ❑ TALSTAR
D ❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
GALLONS APPLIED • � -5 0
i
As per 104.2.6 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
i
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER ❑ OTHER
Payment Terms: Payment due at time of service. �►`
Date Applicator: Evict A Bug Ter ite and Pest Control, Inc.)
ZJ.'4
Date Custo er (Property Owner or Agent) �?��
�' www'.evictabugpestconutrol.com