HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEN
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Planning & Development Services
- Building & Code Regulation Division
a 2300 Virginia Ave
° Fort Pierce, FL34982
772-462-2172 Fax 772-462-6443 SCHNNE®
CERTIFICATE OF TERMITE TREATMENT
St. Luce County
CONSTRUCTION SOIL TREATMENT
PERMIT #: D - O JOB ADD ES % eof�
BUILDER/CONTRACTOR: o
PEST CONTROL CONTRACTOR: E T-A-BUG TERMITE & PEST CONTROL INC.
PEST CONTROL LICENSE #: J13175775
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: . V7� Chemicals used: DOMINION zL
Percentage of solution: •05%
Date of Treatment: 71Y/''i
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-- 't Treatment
Re -Treat
Driveway
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Total gallons used: 2.3 0
Time of Treatment: % 2 -O C)
xSlab
K 1s` Treatment
Re -Treat
Pools
1 Treatment 1t Treatment
Re -Treat Re -Treat
Other Peril eter for Final Inspection
1 Treatment
Re -Treat 2 /
Sig re of Exterminator Datb
Note. There must be a completed form for each required reatment 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 charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites. A weather resistantjobsite posting board
shall be provided to receive duplicate Treatment 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
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 prevention 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.
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State License JB228623
Notice of Preventative Treatment for Termites ?-Y—a �/ '
(as required by Florida Building Code 2326.5 and Broward County Chapter FBC 105.2.2) / J�
SERVICE ORDER NUMBER SERVICE DATE 1 TIME V'' 3� WEATHER CONDITIONS JCS
DEVELOPMENT NAME (PROJECT) CONTRACT R1'S AME CONTACT PERSON . LUCI@ COUi
.� S C S T
STRUCTURE ADDRESS LOT/BLOCK) CITY, STATE, ZIP CODE COUNTY
CONTACT PHONE NUMBER NOTES
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TREATMENT TYPEIAREK
❑ FLOATING MONOLITHIC ❑ PATIO ❑ GARAGE ❑ DRIVEWAY ❑ STEM WALL ❑ ADDITION
❑ CUTOUTS ❑ FOOTERS ❑ FRONT ENTRY ❑ EXTERIOR PERIMETER FOR RENEWAL ❑ OTHER
TREATMENTTYPE
❑ TAMP & TREAT TREAT ONLY ❑ FINAL ❑ RETREAT ❑ BORA CARE TREATMENT ❑ TERMITE BAIT STATION
PR UCT
DOMINION ❑ ADONIS 2F ❑ PREMISE ❑ DEMON TC ❑ TERMIDOR ❑ BORACARE ❑ OTHER
ACTIVE INGREDIENT 1,44 ��r1�-U� 12 If Q
CONCENTRATION / ..
0.05% 0.06% y1.7% 0.12% ❑.25% ❑OTHER— GALLONS APPLIED •'��RM(_TES"-
///
O R q • CF,�
SQUARE FOOTAGE b LINEAR FOOTAGE , t O A dt
CD r
SOARSOARE FOOTAGE VERIFIED r 1
YES ❑ NO ❑ MEASURED OR VERIFIED PER PLANS <
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READY CONDITIONS MET
YES ❑ NO DETAILS
SAFETY CONDITIONS
As per 2326.5 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.)
If this notice is for the final exterior treatment, Initial and date this line {TERMITE MONITOR INSTALLED O YES ❑ NO)
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER OTHER
Payment Terms: Customer's payment in full is due at time of initial service. Customer agrees that a finance charge In the amount of 1S % per annum will
be assessed on all unpaid balances that are not satisfied by the due date. In the event a collection process becomes necessary to recover an unpaid
balance the following fees will be assessed Including but not 1 ited to: collection service fee, attorney%fee, finance charges and non -sufficient funds
pa ant ant f�er will be responsible for payi011 costs a ociated with any collection process.
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Date Applicator (Diligent Services)
Date Customer (Property Owner or Agent)
Corporate 3500 NW Boca Raton Blvd. 1 Suite 714 1 Boca Raton, Florida 33431 1 1-800-DILIGENT I mydiligent.com