HomeMy WebLinkAboutMiscellaneous Compliance Report 2013-10-16 Oct 15 13 05:11p Corp 5417460194 p.2
SPRINGFIELD
THE
+ I BUILDING Eugene
LANE
COUNTY DEPARTMENT, LLC
+ kfGO +
Exterior Wall Envelope
Self-Certification Form
am the general
contractor or the owner-builder at the following address:
/// /71/1 C o6t
Street Address
p 6
City
i'/2 /02
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 and the specific manufacturer's installation instructions where
applicable. [Section R703.1.1 is provided for reference on the reverse side of this
form.]
Signature
Date
This completed, signed form must be presented to the building inspector prior to
request for final occupancy.
•
Revised: 11/10/2011