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Building &Code Regulation Division
2300 Virginia Ave
o • Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: Kl'-'-Z 0 JOB ADDRESS: a a n 3 ,v 51 SA �
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR:
PEST CONTROL LICENSE #: (0 2,67�1
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.
A
Square,feet if area treated: 443 Chemicals used: fF)A Gni
Percentage of solution: r,. 0 5V6 Total gallons used:
Date of Treatment: -4� Time of Treatment:
Footing Slab
1St Treatment 1St Treatment
Re-Treat Re-Treat t,
Arivew y Pools
Is'Treatment 1St Tre ment
Re-Treat Re- at
Other eri a inal Inspection
ist.Treatment
Re-Treat /b
ign of Exter ator Date
Note: There must be a completed form for each required reatment re-treatment and this form must be on the job
site to be picked up by the inspector at time of each ins ction he 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