HomeMy WebLinkAboutCERTIFICATE OF TERMITE TREATMENT 8-21-19BY
33t !l u e cou t/
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave '
Fort Pierce; FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PER T # :
-..f S JOB ADDRESS: ����bl ►� Dr
BUIL ER/CONTRACTOR:
PEST'CONTROL CONTRACTOR:�-
PEST CONTROL LICENSE #:�
We, th, undersigned, hereby certify that we have pretreated the above described construction for
subter nean termites in accordance with the standards of the National Pest Control Association.
'feet if area treated: Z7-
,______ Chemicals used:
Percen 4 ge of solution: 2LY o Total gallons used: �5—
Date o Treatment' C Time of Treatment: : 60
r. oting Slab
1st' Treatment 1st Treatment
Re -Treat Re-
D11 iveway Pools Treat
�e Treatment 15t Treatment
1 e-Treat Re -Treat
O Iher/ ofea�, r t Per' for Final Inspection
1' Treatment
Re -Treat
ure of Exterminator Date
Note; T, ere must be a completed form for each uired treatment or re -treatment and this form must be on the job
site to b picked up by the Inspector at time
fee char each Inspectlon or the scheduled Inspection w1/1 fall and a re-Inspectlon
red.
FSC104 �.6 Certificate of Protective Treatment for prevention of termites. A weather reslstantjobsite posting board
shall be 'r ovided to receive dupl/cate Treatment Certificates as each required protective treatment is completed,
Providin a copy for the person the permit is issued to and another copy for the building Cert/ficat� shall provide the product used, identity of the applicator, time and date of the�ermit r1le.9, The 7reatmer;t
reatment, site location, area
treated, emlcal used, percent concentration and number ofgallons used, to establish a verifiable record of
protectiv treatment. If the soil chemical barrier method for termite prevention is used, f/na/ eater/or treatment shall
be comp/ ted prior to final building approval.
St Luci County requires for the final inspection for CO, a Permanent Sticker to be placed on
•the ele rical panel box cover, listing all the treatments and dates Of applications.
Revised 7/2 /2014