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OU Building&Code Regulation Division
2300 Virginia Ave
Fait Pierce,FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #:.. JOB A66RESS: L-5 P'P-1.6QlA
BUILDER/CONTRACTOR:.. Z(E)hp�dj rcV\�Jewfe--
PEST CONTROL CONTRACTOR: j&1W--4V - to c.
PEST CONTROL LICENSE ck'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'. J!�o C7 Chemicals used:
Percentage of solution; Total gallons used:
e-7
Date of Treatment: Time of Treatment: = C)
—Footing
id Treatment —e Treatment
e'--Treat —Re-Treat
privet- Pools
=V Treatment I'Treatment
_Re-Treat Re-Treat
—Other — Pe meter for Fin spection
e Treab-nent
_Re-Treat
ff SlgnatuplExterminator
Mote.• Mere must be a completed form for each required kb7lent orre-treatment and this form mostbe on,tha job
site to be picked up by the inspector at lime of each Inspection or the scheduled inspection will fall anda-Iv11xVecffvn
fee charged.
FOCI04.2.6 Owtflcate of Protective Traaftent forpreverifion of tetmites. A weather re5istantJobsite posfing board
shall be provided to receive duplicate Treatment Cergflcatag as each required protective treatment Is completed,
providing a copy for the person the permit Is Issued to and another copy for the bullding 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 ofgallons used, to establish a vedffable record of
protective treatment: If the soil chemical barrier method for termite prevention is used,Anal exterior treatment shall
be completedprior to final bulftng approval
St Lucre County requires for the final Inspection for CO,a Permanent Sticker to be placed on
the electrical panel box coverr listing all the treatments and dates of applications.