HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEPlanning & Development Services SCANNEli Building & Code Regulation Division
2300 Virginia Ave BY
Fort Pierce, FL 34982 St. Lucie Count%
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: 15W 0"A JOB ADDRESS: ' 5` k GGS
BUILDER/CONTRACTOR:_ L T� Py'�ny4F -a&tjA
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: leb-5) f
Percentage of solution:.06r
Date of Treatment:
Footing
�Treatment
Re -Treat
Driveway
Sst Treatment
Re -Treat
Other
a 1st Treatment
Re -Treat
Chemicals used: BASELINE
Total gallons used: 4'SZ5�_
Time of Treatment: 0'-, 3 V
� lab
Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
PAUL LUGARA �.211 ".".W.m
2016.m.110931.om 8-11-2016
Signature of Exterminator Date
Note: There must be a completed form 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 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 venfiable 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 CID, a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Kevtsed //2412U14
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: / -6 i 0a'0Co2 JOB
BUILDER/CONTRACTORt <2&A
PEST CONTROL CONTRACTOR: 'Ev
PEST CONTROL LICENSE #: JB175775
SCANNED
BY
St. Lucie Couni h
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: E/.-5 0
Percentage of solution: •051-
Date of Treatment: c
Footing
1" Treatment
Re -Treat
Driveway
1'` Treatment
Re -Treat
Other
la Treatment
Re -Treat
Chemicals used: DOMINION 2L
Total gallons used: 2.1--; 0
Time of Treatment:
Slab
1't Treatment
Re -Treat
_Pools
for Final
Date
Note. 772ere must be a completed form for each requiredatment orrerbeatmentand this form mustbe on the job
site to be p&*ed up by the Inspector at time of each Inspecton or bye scheduled Inspection will fail and a re-Inspectlon
fee charged.
FBC104.2.6CertificateofprotectiveTreatment forpreventionoftermites Aweather resistantjobsitepostingboard
shall be provided to receive duplicate Treatment CerUficates as each required protective treatment is completed,
providing a copy for the person the pennitls 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
protecb've treatment. If the soil chemlcal barrier method for termite prevention is used, final exterlor treatmentshall
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 7/2412014 R
CIMCI Yf I
ILE I V
P
�: »y6
• � I
'� Christ is
Lls Termite Inspectton l _ %"2 323 7921
• Termite Pretreatment
• Pest Control ®l/ICt-A=B111J q" Toll Free:1-877-365-9990
Termite & Fax: 772-340-5990
? •Rodent Service ` � < Pest
• Fire Ant Lawn Service Control, Email: Evictabug@gmail.com
• Whitefly Treatment Inc'' 2373 SW Woodridge St.
i • Licensed & Insured Lic. JB175775 �l`�_b Z
r Port St. Lucie, FL 34953
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.26 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE AN SERVICE I TERMITE SERVICE 'I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE 1 _ 0 3 —I TIME _S' i 6 '
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME CONTACT PERSON
C' n I II rah s LTA A0 �
STRUCTUREADDRES (LOT/BLOCK) ll CI �STATE, ZIP CODE �O f S� OUP .�
NOTES I (-� ` I 1
c?r
❑ FLOATING
❑ MONOLITHIC ❑ PATIO
❑ GARAGE ❑ DRIVEWAY
❑ STEM WALUFOOTERS ❑ ADDITION
❑ CUTOUTS
❑ FOOTER ❑ FRONT ENTRY
❑ RETREAT ❑ BORA CARE TREATMENT
PLUMBING CUTOUTS ❑ SIDEWALKS
❑ TAMP &TREAT
TREAT ONLY El FINAL
❑POOLDECK ^THER'Tf feccr�
�^t❑
4K4—
PRODUCTS
UIBASELINE
❑ OTHER
❑ DOMINION 2LACTIVE INGREDIENT
❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE
SCANNED
BY
❑ TALSTAR St..Lucie County
ACTIVE INGREDIENT - - - . OdMIDACLAPRID�FENTHRIN ❑.DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
06% ❑.12% ❑[.25% ❑.05°/ ❑23% 09% ❑OTHER GALLONS APPLIED 1
" SQUARE FOOTAGE � \ LINEAR FOOTAGE
t y�YES. ❑ NO
MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
❑ NO
)
09LYES
DETAILS
As per-104.2.6 FBC -If soil chemical harder method for lermitepyenti6n is used int= al ezleri r treatment shall be completed prior to final building approval.
i
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.) _ n,
If this notice is for the final exterior treatment, initial and date this line
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER O
Payment Terms: Payment due at time of service.
Date
C
Pest Control, Inc.)
h
Date
r
or Agent)
www.evictabugpestcontrol.com
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
'S z5 CONSTRUCTION SOIL TREATMENT
PERMIT #: 1511- 6?,k 1 JOB ADDRESS: 4s5gl S - G,3 f
BUILDER/CO�NTRACTOR:�7 1, F4 PEA 1 (
PEST CON 1TROL CONTRACTOR: EVICT -A -BUG TERMI E& PEST CONTROL INC.
PEST CONTROL LICENSE #: JB176776
SLHNNEL�
St CUC131Y
C01jM
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:
Percentage of solution:.06% 1
Date of Treatment: / - 2-3- i 7
oting
1- atment
Re -Treat
Driveway
Srt Treatment
Re -Treat
Other
1" Treatment
Re -Treat
Chemicals used: BASELINE
Total gallons used:
Time of Treatment: 5 ! 1
SI
5eatment
Re -Treat
Pools
1't Treatment
Re -Treat
Perimeter for Final Inspection
PAUL LUGARA ;°o,'°o WPA"p.a°"""�. 8-11-2016
Signature of Exterminator Date
Note. There must be a completed form 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 Treatment forprevention of termites A weather resistantjobsite posting board
shall be provided to receive duplicate Treabment Certificates as each required protective treatment is completed,
providing a ropy for the person the permit is issued to and another ropy 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
tD
r-I
Oo
r-I
6-
Port St. Lucie Building Department
This form is to be filled out
by Pest Control Company
Certificate of Compliance nn
(This is a partial treatment only and not a guarantee or warranty) Sy � NED
St. Lucie county
Permit Number: c G� I
Location of Property: D '1CL S - BS I G'A ' /,�-t--(`)`
Legal Description: Section
Pest Control Company
it C a
Company Own
Siginature
,1:
Date Title
//Soil Treatment Company Information
GtJ\C'( ti'S l(f 2F&JeEpe-4W O ZCA
Soil Treatment C pany Name
�i��� i�adctZ3 SA -Vet
Address
�6 15115
Soil Treatment/DACS License #
The building has received a complete
treatment for the prevention of
subterranean termites. Treatment is in
accordance with the rules and laws
established by the Florida Department of
Agriculture and Consumer Services. A
second treatment was done on (date)
—J I as per manufacturer's
specification. If the second treatment is
not required, a copy of the product label
shall be included with this certificate.
Block
Lot
Treatment Information
Date of Trea ent
Chemical Used 1�
Concentration
L5
Gallons Used
43C' I
Method,o Application (soil mixed, etc.)
q
Linear Footage of Area Treated
Second Treatment Information
Date of Treatment
Chemical Used
Concentration
Gallons Used
Method of Application (soil mixed, etc.)
Linear Footage of Area Treated
Please Note: The City of Port St. Lucie does not guarantee or warranty the preconstructlon
soil treatment attested to in the above. The purpose of this document is to show that to
the best of this department's knowledge, the builder has satisfied the requirements of the
Florida Building Code for protection against termites.
This form MUST BE RETURNED to the Building Department
before your final inspection is scheduledl