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�= Building&Code Regulation Division
iCOUNTY 2300 Virginia Ave
• . Fort Pierce,FL 34982
772.462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: /5Q8- 02,-7q JOB ADDRESS: j jr9t,,-; 4
BUILDER/CONTRACTOR: 7�-rr-Nw(.Ams
PEST CONTROL CONTRACTOR: — - < �e
PEST CONTROL LICENSE #:
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: fy d Chemicals used: o
Percentage of solution: & Total gallons used:
Date of Treatment: l%U S� Time of Treatment: !iL &d
Footing
1't Treatment -It Treatment
Re-Treat Re-Treat
Driveway Pg
1t Treatment reatment
. TRe-Treat `. reat
tether r Final
1 eatment
Re-Treat
Signature of nninabor
Note. There must be a completed form for each requlr treatmentorr;eatmentand th/sfonn mustbe on thejob
s/te to be picked up by the Inspector at time of each/ ectlon or the scheduled Inspection will fall and a re-Inspector
fee charged.
FBC104.2.6 Certificate of ProteWve Treatment for prevention of termites A weather reslstantjobsite posting board
shall be provided to receive duplicate Treatment Cwtfirates as each required protective treatment Is completed,
providing a copy for the person the pennit is issued to and another copy for the bulld/ng permit files The Treatment
Certificate shall provide the product used,identity of the applicator,Nme 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 beatment shall
be completed prlorto final bullding 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.