HomeMy WebLinkAboutCERTIFICATE OF TERMITE TREATMENT®3�ann ng & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
RECEIVED
NOV -7 2018
Permitting Department
St. Lucie County, FL
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
ILDER/CONTRACTOR: M
3T CONTROL CONTRACTOR:
ST CONTROL LICENSE #: -,Tl.5�
RESS: �(a-3 7
2, the undersigned, hereby certify that we have pretreated the above described construction for
bterranean termites in accordance with the standards of the National Pest Control Association,
S, uare feet if area treated:
P I'rcentage of solution: -37,::,,
D to of Treatment: LtS
ooting
1" Treatment
Re -Treat
1st Treatment
Re -Treat
Other
1st Treatment
Re -Treat
Chemicals used:
Total gallons used: -,
Time of Treatment:
Slab
1st Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
l �
Signature of Exterminator to
s: There must be a completed form for each required treatment or re -treatment and this form must be on the job
to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re -inspection
charged,
FBC104.2.6 Certificate of Protective Treatment for prevention of termites. A weather resistantjobsite posting board
sh.l;�l be provided to receive duplicate Treatment Certificates as each required protective treatment is completed,
prod ding a copy for the person the permit is issued to and another copy for the building permit files. The Treatment
Ce if/cate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area
tre ted, chemical used, percent concentration and number of gallons used, to establish a verifiable record of
projective treatment. If the soil chemical barrier method for termite prevention is used, Anal exterior treatment shall
be ompleted prior to Anal building approval,
St ,l ucie County requires for the final inspection for CO, a Permanent Sticker to be placed on
they electrical panel box cover, listing all the treatments and dates of applications.
7/24/2014
LM
IL
Mannin
1� r /VicesBuilding Q Code ReguRation Divisio 23®® NY rIQ'�L�tIP@i9`�al d°�@9E�Fort Pierce, FL 34982772-462
Request for 30�Day Te npa °ary Power Release
Date: �4 y
- Permit Number:
Project Address: n o ,? -7 ._..�,/ -
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
I. This temporary power release is requested for the above stated purpose only, and there will be no
occupancy of any type, other than that permitted by construction during this time period.
2. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy, which is Incorporated herein by reference.
3. All conditions and requirements listed in the attached document entitled "Requirements for 30 Day
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order issued if
the Final Inspection has not been approved within 30 days. A fee of $100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
CTRPIA-n in
CONTRACTOR SIGNATURE
DATE
z,ile,
DATE
DATE