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Building&Code Regulation Division
a 2300 Virginia Ave
• • - Fort Pierce,FL 34962
_., ,....__...._. _ 772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT N16
PERMIT #: 5-p-7 - 01,7,1 JOB ADDRESS: 3067 6i, rl es W C,,N , (0f+- Pi er&e.
BUILDERICONTRACTOR: Oo l ti
PEST CONTROL CONTRACTOR: .e
PEST CONTROL LICENSE #!t:
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,
S
Square feet if area treated: ?7 SJ r Chemicals used: iV).—
Percentage of solution: d e?L Total gallons used: 41(')
Date of Treatment: �YZy—) Time of Treatment: 1 Z O
Footing Slab -
1't Treatment I"'Treatment
Re-Treat Re-Treat
Driveway Poo)s
I't Treatment 1st Treatment
Re-I'
a• Re-Treat
Other + it SPerimeter for Final Inspection
1`Treatment2Z��—
Re-Treat
signature of Extermin
Note: There must be a completed form for each required treatment orre-trealmentand this form mustbe on the job
s/te to be picked up by tthe Inspector at time of each inspection ar the scheduled inspecbbbo will fall and a re-Inspection
fee charged.
FBC104.2.6 Certifrrate'ofProtective Tf atrrrentforpreventfon of termites A weather reststan!-jobsite posting board
shall be provided to receive duplicate Treatment CerGdcates as each required protecvve treatmentIs Completed,
providlnq a copy for the person the permit is ksued 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
proiecf/ve treabment. ff the soil chemical barrier melhod for termite prevention&used,final exterior treatment shall
be completedpriar 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 nates of applications.