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SPRINGFIELD
_ UlLDING EUGENE
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Exterior Wall Envelope
Self-Certification Form
I, DA"iS (oNnavet 9.-' SE/ acr) u-c , am the general contractor or the
owner-builder at the following address:
(otB 5 3 5r .
Street Address
City
Sn - 5P2zof3 — 011C'3
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.]
5coTr D/I, 7 •
Print Name
tl St
Signature
Date
Revised:2/8/2010
SPRINGFIELD - --
l�*1 PSPR/NOF/EL'D; REGON ' '
DEVELOPMENT SERVICES DEPARTMENT
225 FIFTH STREET
SPRINGFIELD.OR 97477
PHONE (541)726-3753
ti FAX (541)726-3689
- www.ci.springfeld.oc us
HIGH-EFFICIENCY LIGHTING SYSTEMS
OREGON RESIDENTIAL SPECIALTY CODE (ORSC)
PermitNo.: S11 - 51'2Z013 - Jurisdiction 5paiut511<6
Site Address: /01-0 s°)2 sr
Subdivision/Lot: TRvasrON PLACE LeT ' 13 . •
and/or
Map and Tax Lot:
•
By my signature below, I certify that a minimum of❑ fifty(50)percent, *❑ seventy-five (75)percent, of
the permanently installed lighting fixtures in the above mentioned building have been installed with compact
or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon
Residential Specialty Code N1107.2)1
* Check the 75%box if the additional measure selected to comply with ORSC N1101.1 and Table
N1101.1(2)requires 75%of lighting fixtures to have energy efficient lamps.
Signed: 1. Date: yI(o (ly
Owner enerai Contractor/Authorized Agent
Print -
Name: 5 [oTT DRr"s
Contractor's CCB # ( 620 391 Expiration Date: Zo/t'
1 ORSC Section N1107.2. High-Efficiency Lighting Systems. A minimum of fifty(50)percent of the permanently Stalled
lighting fixtures, seventy-five(75%)percent,if the selected additional energy code measures in the Table N 1 101.1(2)requires
greater lighting efficiency,shall be installed with compact or linear fluorescent,or a lighting source that has a minimum efficacy of
40 lumens per input watt. Screw-in compact fluorescent lamps comply with this requirement
—. The Building official shall be notified in writing at the final inspection that a minimum of the required percentage of the
permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt.
C:High-Efficiency Inter.dac
f eiaiR' - ,- 1 ,y ` v -- � .V.Ti �ek�-K mss.'`. -i fps, �ys;`;�
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SPRINGFIELD - ,AL a olir OF SP8 GREL-D, OREGON ,n - � z eri
DEVELOPMENT SERVICES DEPARTMENT s ' °`' 225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
Moisture Content Acknowledgement Form
I, °Avis cotstC-'« - 50-Mezr uc , am the general contractor or the owner-builder
at the following address:
love s3'I 5r
Street Address
/2 In Fa 14.6
City
Sit - 5P220,3
Permit#
If applicable: n
1-TI3✓'R f
$Tins /M t Lem A
Subdivision/Lot and/or Map and Tax Lot
To conform with the 2011 Oregon Residential Specialty Code (ORSC), Section
R318.2, I am notifying the building official that I am aware of the moisture content
requirement of ORSC Section R318.2 and have taken steps to meet this code
requirement. [Section R318.2 is provided for reference.]
Section 11318.2 Moisture content. Prior to issuance of the insulation/vapor bather
approval required by R109.1.5.2 of this code:
(A)All moisture-sensitive.wood framing members used in construction shall have a moisture content
of not more than 19 percent of the weight of dry wood framing members.
(B)The general contractor or the owner who was issued the structural permit shall notify the building
official on a division approved form that the contractor or the owner who was issued the structural
permit is aware of and has taken steps to meet the requirement in paragraph(A).
Print Name: 5 e owr DAvI J
Signature 1 N. Date yl(o / IK
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