HomeMy WebLinkAboutInspection Docs 1
Planning &Development Services
S , Building &Code Regulation Division
-a . x 2300 Virginia Ave
NAH!5kFort Pierce, FL 34982
L 772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
3'1 01—<60 J bad3 . Doo - Q
PERMIT #: SL c 16-82- 0-?Z JOB ADDRESS: 5- 3 fir,
BUILDER/CONTRACTOR: bouil A Neel Colum-!-9 Cc,,t�rcfc--Fors �1
PEST CONTROL CONTRACTOR: 60f-49( Pf 54 6o4-h..1 1E4L 'rrel. ire
PEST CONTROL LICENSE #: J a Ssq�j
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: � Chemicals used: ! g1IJ- 'qr
Percentage of solution: o -/0 Total gallons used:
Date of Treatment: �/ 3p��s~ Time of Treatment: 3 �
Footing Slab
1st Treatment 1st Treatment
Re-Treat Re-Treat
Driveway Pools
1st Treatment 15t Treatment
Re-Treat Re-Treat
Other Perimeter for Final Inspection
1st Treatment )A 30//
Re-Treat �A/l,�GG A
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 resistant jobsite 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 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
SUPERM1jr+-
"The On Time Concrete Company"° �27
4
CENTRAL CONCRETE SUPERMIX, INC.
-l_)- CONCRETE DISPATCHERS: f jill�l!�i jj�'.I}!?,il; I'I�t i1;ti'i 1!qf.+"' i I
South Dispatch: (305)264-7101
North Dispatch: (561)826-9364 CUSTOMER NO. DELIVERY TICKET Y DATE
Block Dispatch: (305)805-3226
WWW.SUPERMIX.COM
MAIN OFFICE: 4300 S.W. 74th Ave. • Miami, FL 33155
PHONE:.(305) 262-3250 • FAX: (305) 267-0698
SERVING MIAMI-DADS, BROWARD, PALM BEACH, MARTIN & ST. LUCRE COUNTIES
SOLD TO DELIVERY ADDRESS
QUANTITY ITEM DESCRIPTION UNIT PRICE EXTENSION
MINUTES — ALLOWABLE TIME' _ PER MINUTE —
EXTRA UNLOADING TIME CHARGE X$1.00
"6 MINUTES PER CU. YD. ALLOWED', SHORT LOAD CHARGE y
SLUMP, AMOUNT I'� v'_7}' 13,?t�
THIS DELIVERY TOTAL CU. YDS.
OF YOUR ORDER FOR CU. YDS. TAX
CUSTOMER OR HIS AGENT ASSUMES FULL RESPONSIBILITY FOR STRENGTH AND/OR
PERFORMANCE OF ANY CONCRETE PLACED ABOVE DESIGN SLUMP OR WHEN •
WATER IS ADDED. WATER ADDED OYES ❑ NO GLS.
TIME ARRIVED ON JOB STARTED UNLOADING FINISHED UNLOADING LEAVING THIS JOB TOTAL TIME
, 9
SUBJECT TO THE TERMS, CONDITIONS AND `CAUTION"WARNING LISTED ON BOTH THE
FRONT AND BACK OF THIS TICKET.
TRUCK DRIVER I acknowledge that I have received and accepted the materials listed on this ticket. I
understand and agree to the terms on both the front and back of this ticket.
RECEIVED BY: X
CONTROL 211OADING POINTS AT 16 LOCATIONS TO.SERVE YOU BETTER
Q�oa cnH� DOWNTOWN MIAMI
-WEST IEDPERRINE-PEMBROKE PINES
CDEERFIEDBOCA RATON•RIVIERA BEACH AIRPORT STUART W.ROWARDFT.PIERCE E.BROWARD-DE RAY14 ( (
PRODUCERS AND SUPPLIERS OF QUAUTY READY MIXED CONCRETE AND CONCRETE BLOCK NRMCA
'� DELIVERY COPY �
CAUTIONH FRESHLY MIXED CEMENT, MORTAR, CONCRETE OR
GROUT MAY CAUSE SKIN INJURY: AVOID CONTACT WITH EYES WHERE
POSSIBLE AND WASH EXPOSED SKIN AREAS PROMPTLY WITH WATER.
IF ANY CEMENT MIXTURES CET INTO EYES., RINSE IMMEDIATELY AND
REPEATEDLY WITH WATER AND - CHET PROMPT MEDICAL TREATMENT
SAWING, OR GRINDING OF CONCRETE, MASONRY UNITS MAY RESULT
IN THE RELEASE OF DUST PARTICLES WHICH, WITHOUT THE USE OF
PROPER EYE OR RESPIRATORY PROTECTION, COULD CAUSE LYE OR
TSE IRRITATION. THE MATERIAL SAFETY DATA SHEETS FOR THE
PRODUCTS SOLD BY, CENTRAL CONCRETE SUPERMIX, INC. ARE
AVAILABLE UPON REQUEST
UNLOADINGDRIVERS ARE PROHIBITED FROM DELIVERING
CONCRETfE EXCEPT UND-E.R;THE TRUCK'S OWN POWER, AND WHERE
SITE CONDITIONS PERMITTHE SAFE AND PROPER OPERATION OF HIS
EQUIPMENT DRIVERS ARE NOT PERMITTED TO ADD WATER TO THE
MIX �,gR TO CO -BEYOND TH9E- C=URB- LINE, EXCEPT �►P IS- THE
.
AUT ZATION OrTHE PURCHASER/PURCHASER'S AOENTAND HIS
ACCEPTANCE OF RISK FOR ANY LOSS OR DAMAGE.
BUYER, OR HIS AGENT, AGREES TO ASSUME RESPONSIBILITY FOR
CONCRETE, AND ANY PROPERTY DAMAGE RESULTING FROM TRUCK
MAI�'■{8Ip®NGU/��pELIVERY�//)F .DELIBEYOND CURB LIME. ,ALL CIM T ADE
IF IT ECOMES NECESSARY TO BRING ANY ACTION TO COLLECT
AMOUNTS DUE ON THIS INVOICE, PURCHASER SHALL BE RESPONSIBLE
FOR REASONABLE'ATTORNEYS FEES AND COURT COSTS INCURRED
BY VENDOR IN SECURING .COLLECTIONS. INTEREST SMALL ACCRUE
AT 1 1 /2% PER MONTH ON--OUTSTANDINC BALANCES.