HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEPlanning & Development Services SCANNED] �71 00 0
Building & Code Regulation Division BY
LM 2300 Virginia Ave St. Lucie County
• Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
g� kI 13 3[)X,,19`t,�'f9{,
PERMIT # J q to —00r) JOB ADDRESS: g 3t xf, 3110 962 w)>a� Rk&5
BUILDER/CONTRACTOR: 57,5 f ad _ it C
PEST CONTROL CONTRACTOR: EVICT -A -BUG TERMITE & PEST C TROL 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: 20C2 Chemicals used: DOMINIONc2L
Percentage of solution: .05% Total gallons used: 13 )
Date of Treatment: % -CrLf �/f Time of Treatment: 3 mil)
Footing
1't Treatment
Re -Treat
Driveway
1st Treatment
Re -Treat
Other
1st Treatment
Re -Treat
Slab
I' Treatment
Re -Treat
Pools
1 st Tr..�4.r.....4
of
for Final
Note. There must be a completed form for each required tread rent or reltreabnent 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.
FBC304.2.6 Certificate of Protective Treatment forprevention 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 ofgallons 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
• Termite Pretreatment fie.
• Pest Control
• Rodent Service
• Fire Ant Lawn Service
• Whitefly Treatment
• Licensed & Insured Lic.JB175775
It is ✓�,''1oy ' i'2-323-7921
L rP��mr�/n
Bug S� s Tull frog: 1-877 365-9999
<��ye Termite $ / J FIVE 772-349.5999
Pest
Control, Email: Evictabug@gmail.com
Inc. 4293 SW High Meadows Ave.
Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.E and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATEOFSERVICE �. (� TIME ' 3o I r—) -'�A 6. eov93eSS /9-i2 #3Ll3 PnIm F
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME CONTACT PERSON
P`�I� /Ou�%t-I IiC�IU�t�� L/ln�r�r�l� Ll_C tln, xof� ,_5 (./ /�llSr��i1
STRUCTURE ADDRESS (LOTIBLOCK) CITY,
IVc'V�I CJ
\PCMtk I°l10-Pry-1
F,r7A
TREATMENT TYPEIAREA
❑ FLOATING ❑ MONOLITHIC
❑ PATIO
❑ GARAGE
❑ DRIVEWAY
❑ STEM WALUFOOTERS
❑ ADDITION
❑ CUTOUTS ❑ FOOTER
❑ FRONT ENTRY
❑ RETREAT
❑ BORA CARE TREATMENT
❑ PLUMBING CUT OUTS
❑ SIDEWALKS
❑TAMP&TREAT rq!�REATONLY PkiNAL ❑POOLDECK ❑OTHER
PRODUCTS
❑ BASELINE 61-WMINION,2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE. ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
;ERN1IDACLAPRID ❑.BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑ .06% ❑ .1% ❑ .12% ❑ .25% Ml0 ❑ 23% ❑ 9% ❑ OTHER GALLONSAPPLIED
SQUARE FOOTAGE - LINEAR FOOTAGE —200
g�Es ` O NO 04EASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
AES ❑ NO
As per 104.2.6 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 7�
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER THER W (�
Payment Terms: Payment due at time of service.
Date App) ator. (EvictA BuO T mite and Pest Control, Inc.)
Date Customer (Property Owner crAgent) ...r.....ri!!°u,,;,wy'
r www.evictabugpestcontrol.com
/,Iun0:) apn-1 7S
auawpedao 6uJillwlad
Aluno:) apnj •a5
7uau,4jedao 6uµajwj9d
(331333„ Pest Related Services Blot 9 0 8VH
Pre -Construction Termite Treatment a3„t3=
1-800-698-7998 ?FPm 17- --t4 % 71,D, Vqq ,icense #4439
Property Information
Treatment Datr/�� Time: / J
Builder / Contractor Information
Lot Block
Name of Builder
1_
/
r
Shell Contractor
Construction ype
m Subdivision Nae
Monolithic Floating / Stemwall
Street A�r'ess (if known)
)'ZYC�
Patio EntryDriveway
City State Zip
Owner Name (if known)
Product / Treatment Information
Treatment Type (Must check one): Initial Under-Slab—LSupplemental Wood Treatment —Final
Product applied: Bifenthrin Bora-Care Other
Concentration: ' MMV % Mixed Product Applied:�allons
Square feet treated: Linear feet treated:
If box is checked, then either a final perimeter liquid treatment has been completed or a wood treatment is
completed and the following statement is applicable:
CERTIFICATE OF COMPLIANCE: 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 F I a Departnt of Agriculture and Consumer Services.
Applicator's Name (Please Print)
Advantage is a Full Service pest control company offering inside pest control, termite control,
and lawn & ornamental insect protection and fertilization programs. We offer discounts to our
Termite renewal customers! Call 1-800-698-7998 for more information.
2800 NW 22°d Terrace, Pompano Beach, FL 33069 (954) 968-7717 fax(954) 968-2922
www.advantagepest.com