60 & 62 W 10th St CO A-1� L-L%- 1-j �.-11
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
C E R T I F I C A T E 0 F 0 C C U P A N C Y
P E R M A N E N T
Issue Date . . . . . . 7/24/14
Parcel Number . . . . . LOC ID-000022478
Property Address . . . 62 W 10TH ST
ATLANTIC BEACH FL 32233
Subdivision Name . . .
Legal Description . . .
Property Zoning . . . . TO BE UPDATED
Owner . . . . . . . . .
Contractor . . . . . . BEACHES HABITAT
904 241-1222
Application number 13-00003484 000 000
Description of Work SINGLE FAMILY ATTACHED DWELLING
Construction type . . . TYPE 5-B
Occupancy type . . . . RESIDENTIAL
Flood Zone . . . . . . ZONE X
Approved . . . . . . . r>4-6-0�ok
Building Official
VOID UNLESS SIGNED BY BUILDING OFFICIAL
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
C E R T I F I C A T E 0 F 0 C C U P A N C Y
P E R M A N E N T
Issue Date . . . . . . 7/24/14
Parcel Number . . . . . 170812-0000
Property Address . . . 60 W 10TH ST
ATLANTIC BEACH FL 32233
Subdivision Name . . .
Legal Description . . .
Property Zoning . . . . TO BE UPDATED
Owner . . . . . . . . . BEACHES HABITAT FOR HUMANITY
Contractor . . . . . . BEACHES HABITAT
904 241-1222
Application number 13-00003447 000 000
Description of Work SINGLE FAMILY ATTACHED DWELLING
Construction type . . . TYPE S-A
Occupancy type . . . . RESIDENTIAL
Flood Zone . . . . . . ZONE X
Approved . . . . . . . 7"
Building Official
VOID UNLESS SIGNED BY BUILDING 0 --''. '.'CIAL
CITY ' "F ATLANTIC BEACH
CERTIFICATE OF OCC-,;' eANCY WORKSHEET
Date Requested:
Contractor Name:
Permit #:
Property Address: 2- W IV
Legal Description:
Improvements to the above-described property h,: -e been completed in
accordance with the terms of the permit and are xtified to be ready for
occupancy as: D Single-Family Residence
f_1 Commercial
Other:
Lowest Floor Elevation:
Required As .� ItFFE
The following must be completed before issuing Certiji,xtce of Occupancy:
Department Date Notified Date Approved Approved By
Fim-Erept.
Public Works 2,9
Public Utilities 6 134' k1so b) A
Building
Planning
Tree Mitigation
Satisfied
Final Survey with FITE Yes No
All Re-Inspect Fees Paid es No
Termite Treatment _j2Yes No
CITY OF ATLANTIC BEACH
CERTIFICATE OF OCCI "PANCY WORKSHEET
Date Requested: & Ig-t- .—_ -
Contractor Name: V9 E 471-
A,04 '!� /66 7
Permit #: 3N7
Property Address:
Legal Description:
Improvements to the above-described property have been completed in
accordance with the terms of the permit and are certified to be ready for
occupancy as: EJ Single-Family Residence
F� Commercial
Other:
Lowest Floor Elevation:
Required As -- JIt FFE
The following must be completed before issuing Certif, ��e of Occupancy:
Department Date Notified Date Appro i Approved By
Fi=Zopt.
Public Works /Z 1.3 12.'A
Public Utilities
Building
Planning
Tree Mitigation
Satisfied
Final Survey with FFE Yes No
All Re-Inspect Fees Paid _V,_,�XYes No
Termite Treatment /Yes No
-d-
41
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Graham, Shirley
From: Graham, Shirley
Sent: Friday, June 27, 2014 4:58 PM
To: Carper, Rick; Kaluzniak, Donna; Clemons, Malcolm; Walker, Chris
Cc: Daniels, Freddie; Walker, Jennifer; Jones, Mike
Subject: 60 &62 W 1 Oth St 13 3484 and 13-3447
Rob w/Beaches Habitat is requesting a CO inspection for these properties on 6/30 Monday...Rob can be reached at 334
1202.
,SkLrLe� c1ralnum
Building Permits Technician
800 Seminole Rd
Atlantic Beach, Fl 32233
9042475800
saraham@coab.us
Graham, Shirley
From: Walker, Chris
Sent: Monday, June 30, 2014 8:43 AM
To: Walker, Jennifer
Cc: Graham, Shirley
Subject: W 1 Oth c/o
All good her for us.
r,1"i,I-Aa&C e
11)hz�wyelvIev
ro".mi,
A—ml*04-2f7-.5874
lw,r904-242-3475
Graham, Shirley
From: Clemons, Malcolm
Sent: Monday, June 30, 2014 1:33 PM
To: Graham, Shirley
Cc: Walker, Jennifer; Kaluzniak, Donna
Subject: RE: 60 &62 W 1 Oth St 13 3484 and 13-3447
Backflow Inspection OK. Malcolm
From: Graham, Shirley
Sent: Friday, June 27, 2014 4:58 PIVI
To: Carper, Rick; Kaluzniak, Donna; Clemons, Malcolm; Walker, Chris
Cc: Daniels, Freddie; Walker, Jennifer; Jones, Mike
Subject: 60 &62 W 10th St 13 3484 and 13-3447
Rob w/Beaches Habitat is requesting a CO inspection for these properties on 6/30 Monday...Rob can be reached at 334
1202.
Building Permits Technician
800 Seminole Rd
Atlantic Beach, Fl 32233
9042475800
sgraham@coab.us
Graham, Shirley
From: Daniels, Freddie
Sent: Wednesday, July 23, 2014 3:50 PIVI
To: Carper, Rick
Cc: Graham, Shirley; Walker, Jennifer; Layton, Douglas; Nodine, Phil
Subject: RE: 60 &62 W 1 Oth St 13 3484 and 13-3447
Approve PW
From: Carper, Rick
Sent: Wednesday, July 23, 2014 11:57 AM
To: Daniels, Freddie
Cc: Layton, Douglas; Walker, Jennifer; Graham, Shirley; Nodine, Phil
Subject: RE: 60 &62 W 10th St 13 3484 and 13-3447
Freddie, As-built survey satisfactory— proceed with rest of CO inspection. Let Building Dept know results.
Rick
Ricky L. Carper, P.E.
Deputy Public Works Director
City of Atlantic Beach
1200 Sandpiper Lane
Atlantic Beach, FL 32233
rcarper(c-D-coab.us
PH: (904)247-5834
Fax: (904)247-5843
From: Carper, Rick
Sent: Friday, June 27, 2014 5:12 PM
To: Graham, Shirley
Cc: Daniels, Freddie; Walker, Jennifer; Jones, Mike
Subject: RE: 60 &62 W 10th St 13 3,10,' and 13-3447
As-built survey of on-site storage construction required.
Rick
Ricky L. Carper, P.E.
Deputy Public Works Director
City of Atlantic Beach
1200 Sandpiper Lane
Atlantic Beach, FL 32233
rcarPerCcD_coab.us
PH: (904)247-5834
Fax: (904)247-5843
From: Graham, Shirley
Sent: Friday, June 27, 2014 4:58 PM
To: Carper, Rick; Kaluzniak, Donna; CJemons, Malcolm; Walker, Chris
Cc: Daniels, Freddie; Walker, Jennifer; Jones, Mike
Subject: 60 &62 W 10th St 13 3484 and 13-3447
M A P 0 F S U R V E Y 1A
LOTS 1.Z 3 AND 4,BLOCK 66. SECTION W, ATLANTIC BEACH, AS RECORDED
IN PLAT BOOK la.PAGE 34 OF THE CURRENT PUBLIC RECORDS OF DUVAL
COUNTY. FLORIDA.
C
LOW
to
NOTES-
7HIS IS A TOPOGRAPHIC SURVEY
BEARINGS BASED ON THE SOUTHERLY RIGHT OF WAY UNE OF
10th STREET WEST AS BEING SW49OOE AS PER PLAT
NO BUILDING RESTRICTION LINES AS PER PLAT
BENCHMARK USED 15 A MAD NAL AND DISK IN THE EAST
SIDE OF A WOOD POWER POLE ADJACENT TO RESIDENCE N.
72.ELEV.-II.60(N.A.Y.D.ION)
BOUNDARY AS PER SURVEY BY THIS FIRM.JOB ft.
2011-0567
ib.
J\
ilk
01 lo
Ab
5 Un
rol cop
%,A
LOT 3 EXCEP THE
WEST 32.60 FEET
bs ITA
LOT 2
EXCEPT
G, 6�E
T-3 Gl
4,
tp
G,
00'00
.;rr\4
1,01
--I
OA TH S SURVEY WAS MADE FOR THE BENEFIT OF
THE PROPERTY 940M ON APPEARS TO LIE IN EINCHES HABITAT FOR HUMANITY.INC.; OLD
REPUBLIC NAT10NAL TITLE INSURANCE COMPANY;
and DONAHOO,SALL&McMENAMY,P.A.
FLOOD ZONE")r(AREA OUTSIDE 0.2%ANNUAL ANCE
FLOODPLAJN)AS DETERMINED FROM THE'FLOOD
INSUR CE RATE MAP'NUMBER 12031CO400H EFFECTIVE
JUW 3.2013 FOR DUVAL COUNTY.FLORID& I k, -
DONN W. BOATMIGHT, P.S.M.
VALID NTH T THE SIGNATURE AND THE FLORIDA LIC.SURWYOR md MAPPER Nc�LS 3205
ORKIDIAL RAISED SEAL OF A FLORIDA LICENSED
SURYEYOR AND MAPPER-' FLORIDA LIC.SURVEYING&MAPPING BUSINESS No.LB 3672
LAVIN Dr. CL I BOATWRIGHT LAND SURVEYORS, Inc. 1500 ROBERTS DRIVE JACKSONVILLE BEACH. FLORIDA 241-BM I—JULY 15.2D14 94UT-1-W-1-
X-REr 20li-0567.2014-5�5M
MTurner
T, 9 Pest
Control
What's Bugging You?
CERTIFICATE OF COMPLIANCE
FOR TERMITE PROTECTION
INFORMATION REQUIRED AS PER FLORIDA BLDG CODES 104.2.6. & 1816.1
CONTRACTOR: Habitat for Humanity Beaches
PERMIT*
SITE LOCATION: 60-62 1 Oth St W
Atlantic Beach, FL 32233-5702
DATE OF TREATMENT: 06/23/2014 TIME OF TREATMENT: 09:57:00 AM
AREA TREATED: SQUARE FOOTAGE: LINEAR FOOT: 150
IDENTITY OF APPLICATOR: CLARK, RASHAWN
PRODUCT NAME: BORA-CARE, DOMINION
CHEMICAL NAME: DISODIUM OCTABORATE TETRAHYDRATE, IMIDACLOPRID
(DIFFERENT FROM PRODUCT)
(FOR BAIT SYSTEMS-LIST CHEMICAL NAME THAT WILL BE USED IF TERMITES ARE DETECTED)
PERCENT CONCENTRATION: 23.00%, 21.40%
(FOR BAIT SYSTEMS-IF YOU DONT HAVE THE%=TELL HOW MANY STATIONS PER FOOT)
NUMBER OF GALLONS: 2.56GA, 2.00GA
(FOR BAIT SYSTIVIS-ENTER#OF STATIONS USED)
FINAL STATEMENT:
THE BUILDING HAS RECEIVED A COMPLETE TREATMENT FOR THE PREVENTION OF SUBTERRANEAN
TERMITES. TREATMENT IS IN ACCORDANCE WITH THE RULES AND LAWS ESTABLISHED BY THE
FLORIDA DEPARTMENT OF AGRIGULTURE AND CONSUMER SERVICES.
I GREE THAT THE ABOVE INFORMATION IS CORRECT AND REFERS TO THE ADDRESS LISTED ABOVE:
D L B 17
CE I DPE COATRQLQEERAff0R
TUR NTROL, LLC.
MAIN OFFICE
480 EDGEWOOD AVENUE SOUTH
JACKSONVILLE,FL 32205
PHONE:904-355-5300
FAX:904-353-1488
=Turner Jacksonville,Florida Main Office
T 480 Edgewood Avenue,South Jacksonville,Florida 32205-904-355-5300-904-353-1488(Facsimile)
IMCT.T..Post St. Marys,Ga.-912-576-1300 Daytona Beach,Fla.-386-788-8303*Melbourne,Fla.-321-951-3325
ontrol Ocala, Fla.352-351-4386 Port St. Lucie, Fla.-772-621-7905 0 Tampa,Fla.-813-681-6381
What's Bugging You? Toll Free:800-225-5305 41 ww.tumerpest.com
Pre-Construction Home Termite Servicing A.."ement
Property Owner's Name: Lynch/Baker, Beaches Habitat sonable costs of repairs subject to the above limitation.Turner Is responsi-
ble for repairs only If It has been given the opportunity to Inspect the cov-
Covered Premises Address: 60-62 1 Oth 1;t W ered premises In the area requiring repair PRIOR TO THE START OF ANY
City,State,Zip Code:Atlantic Beach, FL 322.1.3-5709 REPAIRS. In the event that damage is discovered by parties other than
Turner,the owner agrees to notify Turner of such damage within 48 hours of
Billing Address(If different): discovery of such damage.
City,State,Zip Code: INITIAL INSPECTION:This Agreement calls for an Initial Inspection of the
Primary Telephone: 904-334-1909 Covered Premises upon transfer of the property from the Builder to the
Homeowner.All charges and fees for the Initial Inspection are included in the
Alternate Telephone: price of the pre-construction treatment, and are the responsibility of the
Type of Structure: Sincile Eamily Residence Builder.
Detached Structures Included: NONE This Agreement contains all the terms and conditions of the Agreement and
no other representations of statements will be binding upon the parties. No
Warranty Start Date: 0613019014 alterations of or additions to this Agreement(other than information to fill in
the blanks) are effective or enforceable unless the alteration or addition is
Turner Post Control, LLC (herein 'Turner" ) is authorized to provide the signed by a corporate officer of Turner.
treatment for the prevention and control of subterranean termites to the
Structure and Detached Structures listed at the above Covered Premises
Address (herein *Covered Premises") on behalf of the Property Owner's
Name(herein'Owner')listed above. Turner Representative: r
INITIAL TREATMENT. This Agreement will become effective upon full pay- Date: 06/30/2014
ment for the Initial Pre-treatment by the Builder.Continuation of the termite
protection is subject to payment of the annual renewal fees by the Owner,or
Builder if unsold after twelve months after the initial pre-construction treat-
ment,and general terms and conditions on the reverse side hereof.
ANNUAL RENEWAL FEE: This Agreement is renewable from
year-to-year, upon re-inspection of the covered premises by
Turner and upon payment of the annual renewal fee of
$95000 - due and payable in full an or before the
Renewal Date of the Agreement. The Renewal Date is
defined as each one year anniversary starting with the
"Warranty Start Date."
Turner reserves the right to adjust the annual renewal fee as
of the second (2nd) renewal year, or any year thereafter.
Following expiration of the 4 year renewal, Turner
reserves the right to require the covered premises to be
completely retreated, at a rate to be determined by Turner,
subject to Turner and owner entering into a now termite
service agreement.
COVERAGE: This Agreement provides for the re-treatment and repairs for
damage to the Covered Premises limited to an aggregate of
1 000 Ono . For as long as this Agreement remains in effect,Turner
w erform any further re-treatment it finds necessary,free of charge,sub-
ill�
ject to the terms and conditions of this Agreement.
REPAIRS: If subterranean termite damage occurs to the Covered Premises
while this Agreement is in effect,then Turner will be responsible for the rea- VNIS"A
E49
Reorder Form No.6035
Rush To Excellence PTinfing,904-367-0100
Pre-Construction Home Termite Servicing Agreement
General Terms and Warranty Conditions
1)This Agreement provides for Turner to perform an initial pre-con- minimum of four inches above the outside grade level.This may
struction treatment and any subsequent treatments as deemed also include the removal of floor covering material such as wood,
necessary by Turner to the structure if a live infestation of the marble,ceramic tile,vinyl or any other floor covering placed over
specified subterranean termites is found in the structure during the concrete slab floors. This may also include the removal of
the effective period of the Agreement. Turner will make such planter boxes,cabinets,bathtub enclosures,or other obstacles to
repairs as necessary to correct damage with infestation subject to allow Turner to gain access to the area requiring treatment.The
the following conditions: customer agrees to pay all expenses to make all non-accessible
•Damage was caused by specified subterranean termites areas accessible for treatment and/or inspection as deemed nec-
• Turner personnel verifies the evidence before it is altered or essary by Turner.
destroyed. 4)The Owner agrees to notify Turner of any additions and/or alter-
ations to the Covered Premises.This may require the Owner to
•All repair work will be performed or supervised by Turner per- pay for additional treatment,service charge and/or adjustment to
sonnel only unless otherwise agreed in writing by both parties. the renewal fee. Failure to notify Turner will terminate this
• If damage is discovered to be a result of conditions other than Agreement automatically as of the date the structural change(s)
subterranean termites or when conducive conditions have con- is made.
tributed to the presence of subterranean termites, the cus- 5) In the event the property is sold, Turner will transfer the
tomer agrees to accept responsibility in such cases for the cost Agreement to the New Owner.The Agreement is assignable at
of repairs. the sole discretion of Turner.
•Turner will repair only the specified areas damaged by the sub- 6) In the event of non-payment of the Initial Treatment,renewal fees,
terranean termites according to the conditions stated herein. cost of repairs performed by Turner caused by conducive condi-
Turner is not responsible for costs incurred to match existing tions contributing to infestation, or any other fees due to Turner
wall coverings,floor coverings,moldings,paneling,tile or other under this Agreement, Turner has the right to terminate this
cosmetic work. Agreement effective the due date of the unpaid fees.
2)This Agreement does not cover, and Turner will not be responsi- 7) In the event of a change in the existing law as it relates to this
ble for re-treatment or repairs to any of the following: Agreement,Turner reserves the right to adjust the Renewal Fee,
•Wood decks, wood steps, wood fences, wooden walk-ways, or amend the terms of this Agreement and/or terminate this
other wooden structures outside the foundation perimeter of Agreement.The State listed in Service Address controls opera-
the covered premises, or any area(s) of the structure where tion of this Agreement.
wood members are in direct contact with the ground. 8) Any claim or complaint of dissatisfaction under the terms of this
•Area(s)where stucco,coquina, Styrofoam and any other mate- Agreement must be made in writing to Turner.Turner is only obli-
rial is applied in a manner conducive to infestation or is in gated to perform under this Agreement provided the customer
direct contact with the ground. allows Turner access to the structure for any purposes contem-
• Area(s) where moisture conditions conducive to infestation plated by this Agreement, including but not limited to re-inspec-
exist,such as but not limited to faulty plumbing, roof leaks,ele- tion, whether the inspection was requested by the Owner or
vations above slab levels such as planter boxes or any other deemed necessary by Turner.
conditions that supply water to termites allowing them to sur- 9) The Owner and Turner agree that any controversy or claim
vive above ground. between them arising out of,or relating to,the interpretation,per-
•Infestations resulting from moisture conditions including but not formance,or breach of any provisions of this agreement,shall be
limited to fungus. settled exclusively by arbitration administered by the American
Arbitration Association, under its commercial arbitration rules,
•Damage to plants,trees,flowers, and/or shrubs adjacent to the and judgement on the award rendered by the arbitrator(s)may be
structu re. entered into any court having jurisdiction.In no event shall either
• Personal expenses including but not limited to lodging, meals, party be liable to the other for indirect, special, or consequential
transportation, loss of use incurred as a result of treatment, damages or loss of anticipated profits.
and/or re-treatment,or damages therein.
•Any other indirect expenses or consequential damages relating
to the existence of termites or termite damage.
• Areas where Turner has documented conditions conducive to
infestation that have not been corrected in a timely manner by
the customer.
• Damages or losses caused by war, fire, earthquake, floods, or
other causes beyond the control of Turner.
3) Customer warrants full cooperation with Turner during the
Agreement period and any renewal period and agrees to maintain
the structure free from any factors or conditions contributing to re-
infestation by specified termites. It is the customer's responsibili- =Turner
ty to correct any conditions that may inhibit proper inspection T,", Pest
and/or treatment deemed necessary by Turner.This may include
removal of stucco, coquina or other exterior siding materials to a ElControl
What's Bugging You?
Subterranean Termite Protection Builder's Guarantee OMB Approval No.2502-0525
(exp.04/30/2015)
This form is completed by the builder.
Public reporting burden for this collection of information is estimated to average 5 minutes per response,including the time for reviewing instructions,searching
existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.This information is required to
obtain benefits.HUD may not collect this information,and you are not required to complete this form,unless it displays a currently valid OMB control number.
Section 24 CFR 200.926d(b)(3)requires that the sites for HUD insured structures must be free of termite hazards.This information collection requires a
licensed Pest Control company to provide the builder a record of specific treatment information in those cases when if any method other than use of pressure
treated lumber is used for prevention of subterranean termite infestation.When applicable,form HUD-NPMA-99-B must accompany the form HUD-NPMA-99-A.
Builders,pest control companies,mortgage lenders,homebuyers,and HUD as a record of treatment for specific homes will use the information collected.
The information is not considered confidential,therefore no assurance of confidentiality is provided.
This form is submitted for proposed(new)construction cases when prevention of subterranean temnite infestation is specified by the builder or required by the lender,the
architect,FKA or VA.
This form is to be completed by the builder.This guarantee is issued by the builder to the buyer.This guarantee is not to be considered as a waiver of,or in place of,any legal rights
or remedies that the buyer may have against the builder.
FHAAtA Case No.:
Location of Stnx:ture(s)(Street Add ,or Legal Description,City,Stele and Zip): 60-62 1 Oth St W
Atianfic Reach, El- 39933-5709
Buyer'sName: Lynch/Baker, Beaches Habitat
Builder is to check and complete either box 1 or box 2.
1.RX PestControl Company Applied Treatment(See HUD-NPMA99B for treatment information)
The undersigned builder hereby certifies that a State licensed or otherwise authorized pest control company(where required by State law)was contracted to treat the
property at the location referenced above to prevent subterranean termites.The builder further certifies that the contract with the pest control company required the
treatment materials and methods used to be in conformance with all applicable State and Federal requirements.All work required by the contract has been completed
unless noted on HUD-NPMA 99B.Where not prohibited by applicable State requirements,the buyer,for an additional fee payable to the pest control company,may
extend the protection against subterranean termites.Contact the pest control company listed on the attachment for further information.
The builder hereby guarantees that if subterranean termite infestation should occur within one year from the date of closing,the builder will ensure that a licensed or
otherwise State authorized pest control company will treat as necessary to control infestations in the structure.This further treatment will be without cost to the buyer
If permitted by State law,the buyer may contract directly,at the buyer's expense,with a pest control company to inspect the property on a periodic basis and use
EPA registered products to control any infestation.The builder will not be responsible for guaranteeing such contracted work.The builder further agrees to repair all
damage by subterranean termites within the one-year builder's warranty period.This guarantee does not apply to additions or alterations that are made by the buyer.
which affects the original structure or Vestment Examples include,but are not limited to,landscape and mulch alterations,which disturb the treated area and create
now subterranean termite hazards,or interfere with the control measures.If within the guarantee period the builder questions the validity of a claim by the buyer,the
claim will be investigated by an unbiased expert mutually agreeable to the buyer and builder.The report of the expert will be accepted as the basis for disposition of
the case.The non-prevailing party will pay the cost of any inspections made to investigate the claim.For further information,contact your State structural pest control
regulatory agency.All service must be In compliance with the International Residential Code.
Type of Service:: Termite Bait System Field Applied Wood Treatment SoN Treatment
1:1 Installed Physical Barrier System
2.R Builder Installed Subterranean Termite Prevention using Pressure Treated Lumber
The builder cortifies that subterranean termite prevention was installed using pressure treated lumber only and certifies that use of the pressure treated lumber is in
compliance with applicable building codes and HUD requirements including Mortgagee Letter 2001-04.Note:Using pressure treated allis as a sole method of
termite prevention Is NOT acceptable and violates the requirements of Mortgagee Leftr 2001-04.
Initial of Builder Date
Attachments:NPMA-99-R
Builder's CompanyName: Hah*tqt fc)r Hilimansty Reaches Phone No: 904-241-1222
Builder's Signature: Date:
Consumer Maintenance Advisory regarding Integrated Post Management for Prevention of Wood Destroying Insects.Information regarding prevention ofwood destroying
insect infestation is helpful to any property owner interested in protecting the structure from infestation.Any structure can be attacked by wood destroying insects.Periodic mainte
nonce should include measures to minimize possibilities of infestation in and around a structure.Factors which may lead to infestation from wood destroying insects indudefoam
insulation at foundation,earth-wood contact,faulty grade,firewood against structure,insufficient ventilation,moisture.wood debris in crawl space,wood mulch,tree branches
touching structures,landscape timbers,and wood mt.Should these or other such conditions exist,corrective measure should be taken by the owner in ordertD reduce the
chances of infestations by wood destroying insects,and the need for treatment.
An original and one copy of this guarantee are to be prepared by the builder and sent to the lender.The lender provides one copy to the buyer at closing and includes a copy in the
VA loan package or HUD insurance case binder.The builder sends one copy to the licensed pest control company which performed the treatment.
Attached is a copy of the state authorized pest control company's New Construction Subterranean Termite Service Record,HUD-NPMA-99-B.
Warning:HUD will prosecute false claims and statements.Conviction may result in criminal and/or civil penalties.(18 U.S.C.1001.1010,1012:31 U.S.C.3729.3802)
form HUD-NPMA-99-A(8/2008)
New Construction Subterranean Termite OMB Approval No.2502-0525
Service Record (exp.04/30/2015)
This form is completed by the licensed Pest Control Company
Public reporting burden for this collection 5TWfo-r—mabon is estimated to average 15 minutes per response,including the time for reviewing instructions,
searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information.This information
iis required to obtain benefits.HUD may not collect this information,and you are not required to complete this form,unless it displays a currently valid OMB
control number.
Section 24 CFR 200.926d(b)(3)requires that the sites for HUD insured structures must be free of termite hazards.This information collection requires the
builder to certify that an authorized Pest Control company performed all required treatment for termites,and that the builder guarantees the treated area
against infestation for one year.Builders,pest control companies,mortgage lenders,homebuyers,and HUD as a record of treatment for specific homes will
use the information collected.The information is not considered confidential,therefore,no assurance of confidentiality is provided.
This report is submitted for informational purposes to the builder on proposed(new)construction cases when treatment for prevention of subterranean termite
infestation is specified by the builder,architect,or required by the tender,architect,FHA,or VA.
All contracts for services are between the Pest Control company and builder,unless stated otherwise.
Section 1:General Information(Pest Control Company Information)
Company Name: Tumar Past r-nntral LLC
CompanyAddress 480 South Fciqp-wnnd Avanua city jacksnirivelle State FL Zip
Company Business License No. .I R I I 93SIR Company Phone No. A04-355--S-300
FHAIVA Case No.(if any)
Section 2:Builder Information
Company Name Hahitat for Humanity Reaches Phone No. 904-241-1222
Section 3:Property Information
Location of Structure(s)Treated(Street Address or Legal Description,City,State and Zip) 60-62 1 Oth St W,Atlantoc Beach, EL 32233-5702
Section 4:Service Information
Date(s)of Service(s) 06/23/2014- 03/14/2014
Type of Construction(More than one box may be checked) [—Xl Slab F1 Basement Crawl [:] Other
Check all that apply:
A.Soil Applied Liquid Termiticide
Brand Name of Termitickle:Rf)RA-rARF DOMINION EPA Registration No. 6"05-1' 53883-929
Approx.Dilution(%): 23.00%,21.40% Approx.Total Gallons Mix Applied: 2.56GA.2-OOGA Treatment completed on exterior: Yes No
0 B.Wood Applied Liquid Termiticide
Brand Name of Termiticide:RORA-CARF-DOMINION EPA Registration No.6"05-11 53883-999
Approx.Dilution(%): 23.00%.21.4o% Approx.Total Gallons Mix Applied: 2,56GA,2.00GA
F-1 C.Bait system Installed
Name of System EPA Registration No. Number of Stations installed
F1 D.Physical Barrier System Installed
Name of System_Attach installation Information(required)
Service Agreement Available?[g] Yes F� No
Note:Some state laws require service agreements to be issued.This form does not preempt state law.
Attachments(List) Pre-r-onStrucHnn Home TArmita Saryodnq AgreAment
Comments The building has received a complete treatment for subterranean termites.Treatment is in accordance with the rules and laws
astahloshAd hy thA Florida Dp-partmnt of Agroculture and Consumer SAMcas (Per the Florida Ruildoncl Code)-
Name ofApplicator(s) MARK, RARHAWN Certification No.(if required by State law) AR119358
The applicator has used a product in accordance with the product* I and state requirements.All materials and methods used comply with state and federal
regulations.
Authorized Signature Date nR/'An/2014
Wanning:HUD will prosecute false laims and staternenConviction may result in criminal andtor civil penalties.(18 U.S.C.1001,1010.1012;31 U.S.C.3729,3802)
form HUD-NPMA-99-B(08/2008)