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FILE COPY
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
RECEIVED
DE1 0 6 r0118
ST. Lucie County, Permitting
CERTIFICATE OF TERMITE TREATMENT scABY �®
CONSTRUCTION SOIL TREATMENT at. [Lucie County
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PERMI �� ®3 • �7
#. JOB ADDRESS. S Cm(�<< ne
BUILDE, CONTRACTOR:
PEST C NTROL CONTRACTOR: -cam
PEST CONTROL LICENSE #: <:Tb19
We, the 'ndersigned, hereby certify that we have pretreated the above described construction for
subterra ''ean termites in accordance with the standards of the National Pest Control Association.
Square f et if area treated:21O Chemicals used: C,ce-_
e of solution: -Z3L
Date ofjreatment: Y� 3
ting
_15t Treatment
—Re-Treat
,eway
_15t Treatment
—Re-Treat
er
1st Treatment
Re -Treat
Total gallons used: 2--
Time of Treatment:
Slab
1st Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
Z��k_ )2
Signature of Exterminator ate
Note: 7�jere 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 cha�oed.
FBC10 .2.6 Certificate of Protective Treatment for prevention of termites. A weather resistant jobsite posting board
shall be rovided to receive duplicate Treatment Certificates as each required protective treatment is completed,
providi a copy for the person the permit is issued to and another copy for the building permit files. The Treatment
Certihc e 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
protect e treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
St Luc a County requires for the final inspection for CO, a Permanent Sticker to be placed on
the e�,�'24/2014
tricat panel box cover, listing all the treatments and dates of applications.
Revised