HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEA1g90��Ft6Fo
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Planning & Development Services
Building & Code Regulation Division
56111 0 T2300 Virginia Ave
• Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: (7
BUILDER/CONTRACTOR:
SCANNED
BY
o4rt J_ SkivrP 4vJI9,
JOB ADDRESS: (4,3 M4A4M r.,,?d D FE Rne�Ge
:L(6
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:. (SO
Percentage of solution: •05%
Date of Treatment: S Z O
� •!'Ce3tme)ty
Re -Treat
Driveway
1st Treatment
Re -Treat
Other
1s` Treatment
Re -Treat
Chemicals used: DOMINION 2L
Total gallons used: 120
Time of Treatment: 10 - CX d
0 t en
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
of Exterminator
2 Ck
Note. There must be a completed form for each requirE3 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 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.
Revised 7/24/2014
• Termite Inspection Je5LIs Christ it (orq 772-323=7921
• Termite Pretreatment EIIICt A -Bug T011 free:1-811-285-9999
• Pest Control Termite & faX:112-349-5999
-,Rodent Service Pest
:ire Ant Lawn Service Control, Email: Evictabug@gmail.com
• Whitefly Treatment Inc' 4293 SW High Meadows Ave.
• Licensed & Insured Li°. J6175T75 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 F17E ANT SERVICE I(1 TERMITE SERVICE I RODENT EXCLUSION &REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE A ;I S J- 0—TIME— 0: O 0
DEVELOPMENT NAME (PROJECT)
CONTRACTOR'S NAME
Q tJ r S —
CO�T� T PERSON �7 �7
PP/I / 7 2 / S
STRUCTURE ADDRESS (LOTBLOCK)
CITY, STATE
��rt.t� 1(1D- fT+�Pvc>e_.
CO Nr�
—S7 Cte,
NOTES /1
ZIP CODE
IKLAIMM IrYr9AKGA _
❑ FLOATING
NdMONOLITHIC ❑ PATIO
❑ GARAGE ❑ DRIVEWAY
❑ STEM WALUFOOTERS ❑ ADDITION
❑ CUTOUTS
❑ FOOTER ❑ FRONT ENTRY
❑ RETREAT ❑ BORA CARE TREATMENT
❑ PLUMBING CUTOUTS ❑ SIDEWALKS
❑ TAMP & TREAT
TREAT ONLY ❑ FINAL
❑ POOL DECK ❑ OTHER
-L
PRODUCTS
-
�lM�7tlEf9�
❑ BASELINE
ES DOMINION
BY
2LACTIVE INGREDIENT
❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE
❑ TALSTAR tl"
at 14Wpill'!rWinto,
❑ OTHER
VE INGREDIENT
CONCENTRATION
VIMIDACLAPRID ❑ BIFENTHRIN ❑ DISODIUM OCTABORATETETRAHYDRATE"_---
0
❑ .06% ❑ .1% ❑ .12°/ ❑ .25% 'P .05% ❑ 23°% ❑ 9% ❑ OTHER GALLONSAPPLIED 140
SQUARE FOOTAGE I( �- LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
❑ YES ❑ NO ❑ MEASURED OR VERIFIED PER PLANS .
JOB READY CONDITIONS MET
❑ YES ❑ NO
"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.)
if this notice is for the final exterior treatment, initial and date this line
FINAL STICKER
STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER ❑ OTHER
Payment Terms: Payment due at time of service. /
care /Ioolirator. (EvictABuc T nnile and Pest Control. Inc.)
Date
Customer (Property Owner orAgent)
www.evietabugpestcontrol.com