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Building & Codc
2300
Fort Pie
772-462-2172
CERTIFICATE OF
9000
rginia Ave
.e, FL 34982
Fax 772-462-6443
RMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: / 9 OS 0 7J &ADDRESS: 2 G S � �j�'"'` 4 L/
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR: sz� k G A/) P 0 1 —Z_
PEST CONTROL LICENSE #:
We, the undersigned, hereby certify that we i
subterranean termites in accordance with the
Square feet if area treated:
Percentage of solution: C 0
Date of Treatment:
Footing
1st Treatment
Re -Treat
Driveway
1st Treatment
Re -Treat
Other
1st Treatment
Re -Treat
pretreated the above described construction for
Jards of the National Pest Control Association.
EOr-P Chemicals used:
Total gallons used:
Time of Treatment:
Slab
1st Treatment
Re -Treat
Pools
1st Treatment
APer*e
eat
Fi nspection
9Sinator 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;
shall be provided to receive duplicate Treatment
providing a copy for the person the permit is issb
Certificate shall provide the product used, identiti
treated, chemical used, percent concentration an
protective treatment If the soil chemical barrier
be completed prior to final building approval.
St Lucie County requires for the final in
the electrical panel box cover, listing al
Revised 7/24/2014
>r prevention of termites A weather resistant jobsite posting board
e UA:ates as each required protective treatment is completed,
d to and another copy for the building permit files The Treatment
of the applicator, time and date of the treatment, site location, area
number ofgallons used, to establish a verifiable record of
method for termite prevention is used, final exterior treatment shall
pection for CO, a Permanent Sticker to be placed on
the treatments and dates of applications.