HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEI.Or 146 9
Planning & Development Services v vO � U
WS 16 rC�l Building & Code Regulation Division
ane M p ylv, 2300 Virginia AveFort Pierce, FL 34982
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772-462-2172 Fax 772-462-6443 S` [VIV ®
CERTIFICATE OF TERMITE TREATMENT Sf.CucieCollnti,
CONSTRUCTION SOIL TREATMENT
_PERMIT #: 0)5 JOB ADDRESS: q'q i &\1e,ne 1 L
BUILDER/CONTRACTOR: F:M nc6
PEST CONTROL CONTRACTOR: -t-InP kit i(1 t�t�y S
PEST CONTROL LICENSE #:_,j(>,2(),",q-7 1
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: I X
Percentage of solution: • 1 2
Date of Treatment:
_Footing
_I' Treatment
—Re-Treat
_Driveway
_lam Treatment
/ Re -Treat
__L�_uther r�l�w�l�,��a �,nev�i n�C
_ 't Treatmen T--
_Re-Treat
Chemicals used: 121 �,�SC` \neo !j
Total gallons used: % Qa I
Time of Treatment: I (� :U a Q VVI
_Slab
_In Treatment
—Re-Treat
_Pools
_I' Treatment
—Re-Treat
_Perimeter for Final Inspection
—ALA
Signature of Exterminator Date
Note: There must be a Completed farm 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 charged.
FBC104.2.6 Certificate of protective Treatmentforprevention of termites. A weatherres/stantjobsite posbng board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment /s completed,
providing a copy for the person the permit fs issued to and another copy for the building permit files The Treatment
Certificate steal/provide the product used, identity of the applicator, time and date of the treatment, site location, area
treated, chemlca/ used, percent concentration and number ofgallohs used to establish a verifiable record of
protective treatment. If the loll chemical barrier method for termite prevention is used, final ex error 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.
:`o p°�' $ -
Cit of Port St. Lucie
y
Building Department
121 SW Port St. Lucie Blvd.
Port St. Lucie, FL 34984 * 772-871-5132
Panda publicweb.cityofpsi.com
Certificate of Compliance
for Termite Protection
(as required by Florida Building Code R318.1)
PERMIT INFORMATION
Permit-#: 19o:r— o? ir7 SCANNF-U
BY
Q01 Avevu I 1 ,a ., Por4 St. LuCiiprnimt%
Address of Treatment
Legal Description (Sec/Block/Lot)
PEST CONTROL COMPANY
Company Na — Ple se Print License Holder Name
?:72- IF9203�\-+I
Phone Number License #
TREATMENT INFORMATION
Method of Termite Prevention Treatment:
Soil Barrier ❑ Wood Treatment ❑ Bait System* ❑ Other (describe)
*Per FBC R328.1.7— a signed copy of the contract assuring the installation, maintenance and monitoring of the baiting
system that is in compliance with the requirements of Chapter482, F.S. shall be provided to the Building Official prior
to the pouring of the slab and the system must be installed prior to final building approval.
The Building has received a complete treatment for the prevention of subterranean termites. Treatment is in
accordance wi h rules and laws established by the Florida Department of Agriculture and Consumer Services.
Authorized Signatur Date
6Lwd
Print Name
Form created 02/25/2019 revised 04/19/19 tv