HomeMy WebLinkAboutMiscellaneous Compliance Report 2013-9-24 I!
SPRINGFIELDHE
i UILDING -
EUGENE
co
LANE j LPEPARTMENT, LLC
OREGON LLB --
Exterior Wall Envelope
Self-Certification Form
I, 15tzEat J 440 , am the general contractor or the
owner-builder at the following address:
3612 \II AS 1.1%
Street Address
Spe4a cif tet,9
City
8lt- Sit loll— 004'17
Permit#
To conform to the 2011 Oregon Residential Specialty Code (ORSC}, Section
R703.1.1, I am notifying the building official that I am aware of the exterior wall
envelope requirements of R703.1.1, and hereby certify that the components of
the exterior wall envelope have been installed in accordance with the code
requirements. [Section R703.1.1 is provided for reference on the reverse side of
this form.]
5'Qature
Mi ct i 3 •
Date
Shared on'spifs02S\dsd'T:\Building Forms\2011 Exterior Wall Envelope.docx Revised 10/1/2011