HomeMy WebLinkAboutMiscellaneous Compliance Report 2013-9-10 (4) Will
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I `4 UILDING
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Exterior Wall Envelope
. Self-Certification Form
I 'iJV t-s ` ) ec 1 ,J- (u ote.5 am the general contractor or the
owner-builder at the following address:AL 3.3 m yvk- S'' .
Street Address
City 7
/ 3 — 0 )o 3Z
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.]
/` /, V l
X�Signature
rl0 -17 •
Date
Shared on'spifs02S\dsd'T:\Building Forms\2011 Exterior Wall Envelope.docx Revised 10/1/2011