HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEplanning & Development Services
Building & Code Regulation Division SCANNED �G
23oo Ucrgirda Ave BY �O
. Fort Pierce, FL 34532 St. Lucie Counfk,
_...._ ._- -._.. 772-462-2172 Fax 772.462.6443
(CERTIFICATE OF TERMITE MATMENT jOs
CONSTRU(� 71ON SOIL TREATMENT
PERMIT #: 16' -7- 03 t� JQB ADDRESS: ®3V3 Ny)I Z TT�2 �(Ivt� �S L
BUILDER/CONTRA,CTOR $ G l�,Vwo
PEST CONTROL CONTRACTOR:
PEST CONTROL LICENSE #:
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance � the standards of the National Pest control Association.
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Square feet if area treated: L --
Percent8ge of solution: d
Date of Treatment:
-_-Footing
1st Treatment
!Re -Treat
,_Driveway
_�11 Treatment
_Re -Treat
_Other
_l� Treatment
_Be -Treat
Chemicals used: 0. � I
Total gallons used:
Time of Treatment: / i " 0
�Sla
1�t Treatment
_Re -Treat
_Pools
1�1 Treatment
Re -Treat
_Perimeter for Final Inspection
ftu2/ 1 V7
Signature of Extermin r
Note. There must be a completed form for each required treatment or fe-treatment and th/s form mustbe on the job
site to be picked up by the inspector at time of each Inspection or the scheduied Inspeetlan wd1 fall and a -re-inspection
fee charged.
FSC1®4.2.6 0VV#rate of protective Treatmsntforpreventhm oftennites A weather reslstantJobsite posting board
shall be provided to receive dupllcate Treatment Certificates as each required protective beatmentis 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, tine and date of the treatment, site /oration, area
treated, chemical used, percent concentration and number ofgallons used, to establish a verifiable record of
protective treatment. if the soil chemical bamarmethod for termite prevention Is used, final exterlor treatmentshaU
be completed prior to final building approval.
St Lucie County requires for the final inspection for C®, a permanent Sticker to be placed on
the electrical parcel box cover, listing all the treatments and dates of applications.
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