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Planning &Development Services
Building &Code Regulation Division .,FEB 2 9 2016
rKwaijo 2.300 Virginia Ave
• Fort Pierce,FL 34982
772-462-2172 Fax 772462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: 102— GY7j� JOB ADDRESS: glop 3c°e,r-
BUILDER/CONTRACTOR.• /3 r1 _._CincrrTz 3 q�1
PEST CONTROL CONTRACTOR: _
PEST CONTROL LICENSE #: �✓�iS'"S"9s�
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: /u3"F✓`
Percentage of solution: G Total gallons used; Gc-ryon.s
Date of Treatment:12—�fie Time of Treatment:
—Footing Slab
1st ireatment a Treatment
�_ Re-Treat Re Treat
Driveway Pools
1 k Treatment 11t Treatment
Re-Treat Re-Treat
Other Perimeter for Final Inspection
1 'Treatment
_ � r
Re-Treat
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 inspecNm will fail and a re-inspection
fee charged.
FBC104.2.6 Certificate of Protective Treabnent for prevention of termltes A weaffierresistant jobsMe pasting board
shall be provided to receive duplicate Treatment Cert&ratas as each required protective treatment is completed,
provlding a copy for Nie person the permit is Issued to and another copy for the bullding permit fries The Treatment
certlllcate shall provide the product used,identity ofthe app!lcator, lane and date of the treatment;site location, area
treated,-chemical used,percent concentration and number ofgallons used, to establish a verryfrable record of
protective treatment: If the soil chemical barrier method for termite prevention is used,final exterior tmatment shall
be completed prior to final buliding approval.
St Lucie County requires for the final inspection fbr COr a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014