HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEPlanning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
�e Fort Pierce, FL 34982 SCANNED
772-462-2172 Fax 772-462-6443 BY
St Lucie rhmty
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: / - D W 'Z-JOB ADD S
BUILDER/CONTRACTOR: 3 Z 5-Z
PEST CONTROL CONTRACTOR: VICT-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: _20a Chemicals used: DOMINION 2L
Percentage of solution: .05% Total gallons used: 20
Date of Treatment: 2 Time of Treatment: '9, 0 G
Footing
1s` Treatment
Re -Treat
-Driveway
1st Treatment
_;:F�Re-Treat -
�other ��/ r C
1st Treatment
Re -Treat
Note. There must be a completed form for each
site to be picked up by the inspector at time of d
fee charged.
Slab
1'` Treatment
Re -Treat
Pools
1't Treatment
Re-lTpeat
Perimeter Tyr Final In
Date
went or re -treatment and this form must be on the job
or the scheduled inspection will fail and a re -inspection
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 thebuilding permit files. The Treatment
Certificate shallprowde 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.
Revised 7/24/2014
LAQ4
• Termite Inspection 5V5 Christ is �o 0772-323-7921,
• Termite Pretreatment �® f et A -Bug rp Tull fre2:1-817-385-9999
• Pest Control Termite & fuX:11Y-349-5999
• Rodent Service Pest
• Fire Ant Lawn Service -- Control, Email: Evictabug@gmail.com
• Whitefly Treatment Inc. 4293 SW High Meadows Ave.
• Licensed & Insured Lic. JB175775 Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6, 105.10 & R318.1 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE II TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE 16 - t I - (IR1 TIME Ii - (9 0 erml)1 I qeg oerlj(�oL�
DEVELOPMENT NAME (PROJECT) F e6 CONTRA-C`TOR'S NAME CONTACT PERSON �
STRUCTURE ADDRESS (LOTIBLOCK)
72
CITY, STATE
/ COUNTY
M e iiArr r 4ne4n
%J, fS
(��c e
NOTES
'ZIP CODE
'e
fir
or e- r e�C f
e("h f
TREATMENT TYPEIAREA -
` t Og 5r
❑ FLOATING MONOLITHIC
❑ PATIO
❑ GARAGE
❑ DRIVEWAY
❑ STEM WAUJFOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER
❑ FRONT
ENTRY ❑ RETREAT
❑ BORA CARE TREATMENT
❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TAMP & TREAT TREAT ONLY
Cl FINAL
❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE 91DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
CONCENTRATION
SCANNED
St. LuciaCounty
,01MIDACLAPRID O BIFENTHRIN --El DISODIUM OCTABORATE-TETRAHYDRATE
ri
❑ .06% ❑ .1%
❑ .12% ❑ .25% A.05%
❑ 23%
❑ 9% ❑ OTHER
GALLONS APPLIED 21 5
SQUARE FOOTAGE
2
I O B
LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
AYES ❑ NO
JOB READY CONDITIONS MET
°YES ❑ NO
MEASURED OR VERIFIED PER PLANS
DETAILS
"Certificate of Compliance"
As per 104.2.6,105.10 & R318.1 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.) Q�
If this notice is for the final exterior treatment, initial and date this line I1
FINAL STICKER
❑ ELECTRICAL PANEL ❑WATER HEATER
Payment Terms: Payment due at time of service.
/o-//- /
Date
Date
21
(EvictA Bug Termite and
C -e-41
Customer (Property Owner or Agent)
Control, Inc.)
www.evictabugpestoontrol.com