801 Begonia St RES19-0304 Form Board FORM BOARD ELEVATION CERTIFICATE
Date _ r -s !moi Permit Number: XL----5/ -6,30V
Address:
All American Surveyors Work Order #
Required Slab Elevation on City Approved Site Plan:
Actual Elevation of Form Board or Grade Stake:
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Survey Company:
ALL AMERICAN SURVEYORS OF FLORIDA INC.
3751 San Jose Place, Suite 15
Jacksonville FL 32257 Work Phone: 904-279-0088
Signature of Surveyor: (PartyChief)
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Turner MAIN OFFICE:480 EDuWOOD AVENUE,SOUTH, JACKSONVILLE,F_osDA 32205
!"r"Pest P-oNt:_909-355-539fLt F+z x-353-1488•Tou FREE 800.22i-53H±•,-nRMcnecsi sate .
ST.MARTS,GA.-912-576-1300 OCALA,FLA.-352-351-4386
Control Orrioi A BeACK,Fu.-386-788-8303 Pont ST.LUCIE,FLA.-772-692-0078 • '
What's Bu•ging You? MELBOURNE.Fu.-321-951-3325 Tina.FLA.-813-681-6381
NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES
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(as required by Florida Building Code, FBC 104 2.6)
Address: SO 1:,. ..,0., k•
Lot: _ AkkIPCIA V 0'.!aJ Block: Date: 1l lg
ALL STRUCTURAL CHANGES
BORA-CARE Termiticide(Wood Treatment) ARE TO BE REPORTED
Product Used FOR RETREATMENT
Disodium Octaborate Tetrahvdrate 23%Active Ingredient
Chemical used(active ingredient) Percent Concentration
Application will be performed onto structural wood at dried-in stage of construction
Stage of treatment(Horizontal,Vertical,Adjoining Slab.retreat of disturbed area)
1 BORA-CARE Termiticide application shall be applied according to EPA
registrated label directions as stated in the Florida Building Code Section 18.16.18.
' (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE
OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION)