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Home My WebLink AboutTERMITE TREATMENT CERTIFICATEAPPI DATE I TIME INSPECTOR TECH mazaza—mg—a—mro N M M�Wmr=z MM N W DATE TAKEN: I BY: Services, LLC Martin 772-287-8486 • St. Lucie 772429-7716 Indian River 772-567-7392 • Palm Beach 561-746-7364 SCAN Corporate Office 13Y ✓Virginia lh� 01 Avenue, Suite A - Fort Pierce, Flo 2=V StLL, Cie County FOR FAST PROFESSIONAL SERVICE CALL CUSTOMER INFORMATION Amt. # 7 71-7 SERVICE REQUESTED 1)E a -C � -e A 61 4 -TIC r, 0 UW �K?/o ADD ES SOURCE FL C11-Y STATE L 12- ZIP CODE/GRID !CONTRACTS: . HOME TEL # WORK TEL # DIRECTIONS PAYMENT CREDIT CARD INFORMATION AUTHORIZATION AMT CODE DATE CARDT f � Pp/_o V ATIME SVC T YPE CHECK # / CA'D # EXP'DATE l 2.- 3.- 4.— TOTAL DUE TOTAL AUTH. DEFERRED DATE CARDHOLDER NAME (If different from above) I AGREE TO PAYABOVE TOTAL AMOUNT ACCORDING TO CARD ISSUER AGREEMENT (Visa/MasterCard Customer Inquiries Call 1-800-920-1079). SIGNATURE: DATE: VALUED CUSTOMER COMMENTS: SALES TECH COMMENTS:, PEST CONTROL / FLEAS OTS TERMITE FUME MATERIAL INSPECTED Evidence Treated MATERIAL TREATMENT SITES TREATED Name (%) & Amt SITES �1(=Y/N) n (Y/N) Na8(0/.)&Amgynt OAA T- Mulch/Flowerbeds Foundation Woodpile/Garbage Area Crawl Space Alr Doors/Windows/Eaves Interior Walls Attic/Crawl Space Door Frames Underneath Appliances Window Frames Wall Voids/False Bottoms Bath Traps Cracks/Crevices Attic Drawers/Cabinets/Closets Other Other TARGET PESTS Time/Beg:' S-,7 Comp: TOT. Endors hereon acknowledges receipt of and satisfaction for se ice endered. certi y theMbove to be true and an accurate record of my operations. CUSTOMERS SIGNATURE V L DATE W&eTECHNICIAN I 0610512019 16:21 Wipeout Pest &Termites f AMM 429 3229 P.001 l001 tau-v�/l .-,. Planning & Deveiolimgnt Services Ric Building & Code Regulation Division2300 FF� rginia Ave Fort Pierce, iFL 34982 �e"�i/✓U� ®�?�19 772-462-2172 Fax 772-462-6443 St G vie un y enE CERTIFICATE OF TERMITE TREATMENT .CONSTRUCTION SOIL TREATMENT ' PERMIT #:_q�libq I 1 JOB ADDRESS: Qq V .5 -3 -4 S4-- BUIhDER/CONTRACTOR: ' PEST CONTROL. CONTRACTOR: PEST CONTROL LICENSE #: 7Y-4Z'0 a 5 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 Assodition. Square feet if area treated: Percentage of solution.: P Date of Treatment: Footing �lst Treatment Re -Treat Driveway 1� Treatment Re -Treat Other 1s` Treatment Re -Treat Chemicals used: o V"I , n k o Vl Total gallons used: 161 Time of Treatment: • Tj e-''l Slab. 15t Treatment Re -Treat Pools 15t Treatment Re -Treat Perimeter for Final Inspection Signature of Extermi or ' Date Note: There must be a completed form for each required, treatment or re -treatment and this form must be on the jab site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re-Inspecttion fee charged. FBC104.2,6 Certilicate of Protective Treatment for prevention of termites A weather resistant jobsite posting board shall be provided to receive duplicate .Treatmdnt Certificates 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 Certiricate 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 Ofgallons 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 Anal building 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. 0410912019 11:17 Wipeout Pest T�lMltes _I�AI}7724293229 P.0011001 Planning & Development Services Building 8k Code Regulation envision 2300 Virginia ,Ave Fort Pierce, FL 34982 . 772-402-2172 Fax 772-462-6443 CERTIFICATE aF TERMITE TREATMENT CONSTRUCTION SOIL ,TR,EATMENT PERMIT #: �� 1l� JOB ADDRESS.: 7,�2/_�� BUILDER/CONTRACTOR: PEST CONTROL CONTRACTOR:• -e $' c ✓.i PEST CONTROL LICENSE' #: to 6-IN251- We, the undersigned, hereby certify that we have pretreated the above described constructionfor subterranean termites in accordance with the standards of the National Pest Control Association. Square feet if area treated: -X — Percentage of solution:. a __ Date of Treatment; ootin ✓ 1�` Treatment. -Re-Treat -Driveway Is' Treatment Re -Treat Other Ist Treatment Re -Treat Chemicals used: Total gallons used: Time ofTreatment' $ - Slab 1.,` Treatment Re -Treat . Pools '1.51 Tre ent Inspection Date Note. There must be •a completed form for each required treatment or k*-eatment and this form must be on tiie job site to be picked up by the inspector at time of each inspecVon or the scheduled inspection will fail and a re -inspection fee charged. ; FBC104.2.6 Certificate of ftective treatment for prevention of termites. A weather resistant jobsite posting board shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed, providing a dopy for the person the permit is issued to and another copy for the building permit files The Treatment Certificate shall provide the product used, identity of the' applicator, time and date of the treatment, site location, area treated, chef 7kal use4percent concentration and number orgallons used, to establish a verifiable record of protective treatment. If the soil chemical barrier method for termite prevendon is used, final exterior treatmentshall be completed prior to final building approval. St'I_ucie County requires for the final inspection for CO, a Permanent Sticker to be placed on the electrical panel box coven listing.ail the treatments and dates'of applications. •• Aevlsect //;44/2U14