HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATESCANNED'
Planning &Development Seces BY
t 6uulding &Code R�ula>on,Dnnsion St. Lucie C.punty
COUNT 23,00 VirgimaAve
I --_ D A Fort Pierce, FL 3498ZO
7;72 462 2 72 Fax 772 46210443
CERTIFICATE OF'T1E OTE TREATMENT
CONSTIt CT. -ION SOIL TREATMENT
i PERMIT*:'Iqr JOB ADpRES5: A i"M
B 'ILDER/CONTRACTOR CT"a UGrErmnlTEa'PEsrCoHrn rv' -
' L
PEST',CONTROL CONTRACTOR' c
-.
PEST CONTROL LICENSE
�We, the undersigned, her•e6y,cerbfy:that we have pretreated the above descnbed-Construciion foi ri
subterranean termites in accordance vnth;the standards of the National i'eshControt,Associa6on.,
5 DOMINION 2L
Square.feet,if area treated ; g�a oyp Chemicals used-.,t = ^
P_ ercentage of<solution ash,, Totalgailons used _t7a
tots Time Hof Treatment.
D"ate df Treatment:
' F.dottng Stab
1 Treatment V Treatmenti•
Re -:Treat Re Treat
i t Pools.
Driveway
! 1-Treatment. f,
at
( Re=Treata e`Tre -
'y Other mefer for Final Inspe bn
1 Treatment
Re 'Treat
-S nature of Etter" ator. Date
Note: There must`be a completed form for each rEguv baatment'o r beabrteand is form must ire on tiielob-
srte"to beplcked up;bythe rnspectorat;time ofeach /nspecbon or bye scheduled/nson wr//fai/and are mspecGon'
Ape charged
FBC104'2 6 Cerbfiote ofProtedae Treatment for'- wwe6n ofterinrtds A �veabierreslstantlobsite pvsbngGpard
! shall be provided toac�cerve dupl cafe +Treabment-erbfrcates as each requrred protective treabnentrs comp/eted,
3. providiaq a copyfor the person the perm/trs Issued to and another copyfor the budding pernrt files .The Treatment
certificate shall proyrde the product user/, rdenbtyof the 2ppl/cator, time and dateof the treatment, s![e locabop,;area "
treated chemica/,used, percent mncentrabon and_number ofga/loos used,'0 eslablrsh a ver1ft'ab/e redird of
protedrvetreatinent If the sod Chemicalbarrrermethod.forlermitep.rvehdonrsusedfinaL:extenor-lreatmentsha//
be mrrip%ted pnor;to tfnal budding i,&oW
,St Lucie County:requires for the finalr�nspectjon[&r CO, a: Permanent.Sticker to be piaeed:on
the electrcal;panel"box>covera'isting.allthe treatments and dates of appiicahons
Revised 7/24/20P4 -
Planning & Development Services MAY 2 'Or 1019
MV Building & Code Regulation Division permitting Department
2300 Virginia Ave st, Lucie county
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443 SCANNED
CERTIFICATE OF TERMITE TREATMENT St. LBYucie County
CONSTRUCTION SOIL TREATMENT
PERMIT #: I Fo3—P ioc? l JOB ADDRESS: ':�o q5-- l(jw Ro (e,l �' c,QJ
BUILDER/CONTRACTOR: /'/'5>4 Sys f
PEST CONTROL CONTRACTOR: EVICT -A -BUG TERMITE& PEST CONTROL INC.
PEST CONTROL LICENSE #: JB175775
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 Association.
Square feet if area treated: F6-0
Percentage of solution: -0,9%
Date of Treatment: 2018
/F49tirtg
15t Treatment
Re -Treat
Driveway
lst Treatment
Re -Treat
Other
lst Treatment
Re -Treat
Chemicals used: DOMINION 2L
Total gallons used
Time of Treatment:
51; �i?c
Slab
Sst Treatment
Re -Treat
Pools
lst Treatment
Re -Treat
xxxxx Perimeter for Final Inspection
PAUL C LUGARA JR; 01pt0y" ne°°y' CWv JR
o.nc=810Wimxndar
Signature of Exterminator Date
Note. There must be a completed form for each required treatment orre-treatment and this form mustbe 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 ofProtecfive Treabmentforprevention of termites. A weather resistantjobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treabnent is completed,
providing a copy 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, chemical used, percent concentration and number of gallons used, to establish a verifiable record of
protective treatment. If the soil chemical barrier method for termite pre venton is used, final exterior treatment shall
be completed prior to final 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.
Revised 7/2412014
• Termite lnspeition
Christ is
772-323-7921
• Termite Pretreatment
Toll fPee:1-877-385.9999
• Pest Control
• Rodent Service
FRI. 772-349-5999
• Fire Ant Lawn Service
Email: Evictabug@gmail.com
• Whitefly Treatment
4293 SW High Meadows Ave.
• Licensed & Insured
Li!JIB1751,7*715•
Palm City, FL 34990—
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE II TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEWARIA P IZNT
DATE OF SERVICE — 7
TIME B • i G
BY
St. Luclo County
DEVELOPMENT NAME (PROJECT) y
CONTRACTOR'S NAME
CONTACT PERSON
STRUCTURE ADDRESS(LOTIBLOCK) �. CITY, STATE / COUNTY
NOTES _ ZIP CODE
a
❑ FLOATING
/ MONOLITHIC
❑ PATIO
❑
GARAGE
CI DRIVEWAY
❑ STEM WALUFOOTERS ❑ADDITION
❑ CUTOUTS
❑ FOOTER
❑ FRONT ENTRY
❑
RETREAT
❑ BORA CARE TREATMENT
❑ PLUMBING CUTOUTS ❑ SIDEWALKS
❑ TAMP &TREAT
,gfREAT ONLY
❑FINAL
❑POOLDECK
❑OTHER
PRODUCTS
❑ BASELINE
O DOMINION 2LACTIVEINGREDIENT
❑
TERMIDOR SC ❑
BORACARE ❑ PREMISE
❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
d,IMIDACLAPRID ❑ BIFENTHRIN ❑
DISODIUM OCTABORATETETRAHYDRATE.
CONCENTRATION
❑..06% ❑ .1%
❑ .12% ❑ .25%
d.05A ❑ 23%
❑ 9%
❑ OTHER
Q
GALLONS APPLIED (lJ
S � C)
SQUARE FOOTAGE
73
LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
e6YES ❑ NO
JOB READY CONDITIONS MET
)J YES ❑ NO
,,3 MEASURED OR VERIFIED PER PLANS
DETAILS
Asper 104.2.6 FBC -If soil chemical barrier method for termite prevention is used. Final exterior treatment shall be completed prior to final building approval.
Certificate of Compliance: The building has received a complete treatment for the prevention of subterranean termites. Treatment is in accordance with rules
and laws established by the Florida Department of Agriculture and Consumer Services. (Per the Florida Building Code.) M
If this notice is for the final exterior treatment, initial and date this line
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER
Payment Terms: Payment due at time of service.
Date
❑ OTHER
AppJiEator. (EvictA Bug Termite and Pest Control, Inc.)
Date Customer (Property Owner or Agent)i
www.evictabug pestcontrol.com
n,
In
-A RECEIVED
P t es
I
"Pr6iLCons'truct ton Te-iAlif(e,Treatmaint':
-Licmse#4439. UN 12 7019
1-800-698-7!p98 a
.-I -- 1. eon
7j er itting Department
"S . Lucle County
Propel information
' Fr
211" Vk
IN
77'vAT e
constrol -tion Type
Lam, I
teMWI�
NNED
nxtMR)
j
C+elY
�—D.Vd% y—
e
County
zip,
City 7-07
o VIP. kw : wn)
Frodid I �-reatm'enfw rMation iI
UrAnnent TAX ¢ttd at check DonesLatill TJ UPPIC
13 Pf6dW applitcl-, MUL
fuxcd
%
B)ROwingstatement nelpi)lie ble
J6
UN rhe 'g as rev
COMP !,ICERT[nCATE"O� L CE* c0i'pidwftin Mcnt I
1 6erantion of sabtm LMeaR Unn'tes. Tr;al tent is in a=Qr4= with the rules and iws'.
Tom ep e
�cstabiiihcd'by the F1 W66 2rtQ1nt0f'AgrlcUIt*and,Cotw
2' i r/��A
Wcsbrlu Name Menge Print)
;
in:; twi'atoim��Potect�s�and f�rtilzatR*r4ajR�RstaM
t98=7R98,fermorinfnzmapna
L iidva