HomeMy WebLinkAboutMiscellaneous Compliance Report 2010-9-1
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225 FIFTH STREET
. . ... . . SPRINGFIEW, OR 97477
.. . . . .. . . PHONE (541)726-3753
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. . . . . . FAX (541)726-3689
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... .. . . ... . . WYiw.ci.springfield.or.us
MOISTURE-CONTEN'J: ~C::KNf>'''''LE-DGEMENT FORM
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builder at the following address:
3 / ~ ~'b {J Lll41 P ",;\; L
Street Address. , (
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)13(0- 00 /0 V
Permit #
Hllsr
, am the general contractor or the owner-
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If applicable: r -:tt
!J :i\v~ H t'e~UV) Lo-r {3
Subdivisio ot
Map and Tax Lot
To conform with the 2008 Oregon Residential Specialty Code (ORSe), 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 R318.2 Moisture content. Prior to issuance of the insulation/vapor barrier approval
required byRI09.1.5.2 of this code:
(A) All moisture-sensitive wood framing members used in cunstruction shall have a
moisture .contep.t 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).
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Signature
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1~/- /0
Date
X:\Moi.sture Content Ac:know Form.doc
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PNWS.AWWA
98868.8
'ENEW
'0 EXISTING
BACKFLOW ASSEMBLY TEST REPORT 0 REMOVED
PROPERTY V C _' 0 REPLACEMENT
OWNER: ....0. S T Or]:.,1 (LJ L TI(:>V"\ PHONE: 51 7- :::;$.5$
~~i':s~:~Ab(f) M(J..;':",IlVL flue.
CITY e V"'1LVlE:.... V STATE
ASSEMBLY ~ 15 ~ ...... I """J;- /
ADDRESS:':::> ...s .!-~;).),'. (i.S ~r. ,
. ~ STREET
oR.P.B.A. '0 D.c.V.A..D R.P.D.A. 0 D.C.DA OP.V.BA 0 S.V.BA 0 A.V.B. 0 AIR GAP
SIZE: ulJ.~ MAKE: lJ I Ie, " 5 MODEL: ""1S rf) X I.. T
~~~i~OR: Sul? ~~~~R ')1832.'-5
ASSEMBLY / I. I .[ h
LOCATION: l P+. S V>l. ,) Ou..} e I
oK. . ZIP '7,"-/08
cfi'-l76
REDUCED PRESSURE ASSEMBLY P.V.BA / S.V.BA INITIAL\TEST
'I CHECK Ifulil!lllMllllJ:HEP~J AIR CHECK PASSED 61
PRESS DROP (A)I CHoCK #1 INLET 'FAILED O~
INITIAL RELIEF VALVE (B)ITIGHT '1,:]') .9 OPENED AT; PRESS DROP
TEST OPENED AT DATE:
MIN 2 PSID iLEAKED 0 PSlD I 17 !I@
RESULTS BUFFER ~ ~
A. B~ I CHECK #2
MINJPSI ITIGHT o2.L DID NOT FAILED
RELIEF VALVE OPEN 0 0 SYSTE'1)(
0 o iLEAKEDO PSlD PSI ,
PASS FAIL ,
COMMENTS J2..c: -1J! 0,tCnZE.D i31/(KFLi:>~.
REPAIRS
AND/OR
PARTS
REDUCED PRESSURE ASSEMBt. y P.V.B.A.lS. V.B.A. . AFTER REPAIRS
'1 CHECK ""'*:%;~*};' DATE:
TEST PRESS DROP ,(A) CHECK #1
RELIEF (a) I TIGHT 0 - OPENED AT PRESS DROP I I
AFTER OPENED PSID
REPAIRS -,~ _ : ~HECK #2
BUFFER PASSED 0
A-8- TIGHT 0 PSIO
-,~ PSID PSID
IN COMPL.ETING AND SUBMrmNG nus TEST RePORT. TIlE TESTER CERTIFIES TI{AT l1-IE
ASSEMBLY HAS BEEN TEsn:D AND MAINTAINED IN ACCORDANCE WrT1-I Al.L APPLlCABl.E
RULES AND REGULATIONS OF TIfE WATER SYSTEM, AND STATE REGULATIONS.
GAUGE CALIBRATION DATE:J. 16 ItA DETECTOR ,METER READING
\ '\ ()./YvVJ.... '1l1- t.J ~ Lf'5 3 /
TESTERSl1NAlURE"...)/iMLc M. W:ll\CINS,oN Dlog8t?,<(<;'
TESTERS NAME'PRlNTEDr. D. &;0'- -<-/06;2. G /i..'_" c~<: .0<< '-r IY@'f SilHA!'''.!'<h,9
TESTERS ADDRESS It, 1/ A r-J c {..~J . I I( Ii. f I- ~ J ~:.[ . J: <. " r PHON"
COMPANY NAME il.,/!
I, 1 0 SERVICE RESTORED
REPORT RECEIVED BY
(REPRESENTATIVE OF OWNER)
WHITE WlteJ System Copy
PINK. Customer Cepy
YELLOW - Tater Copy
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05/19/2011 05:45
5414852292
LOWES WEATHERIZATION
PAGE 01/01
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A"ICGUARD
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!1 PREMIUM LOOSE-FILL F1BER\?LASS INSULATION )
H J/!f j)""C/..,1 ~s'UtAtION CERTIFICATE
Manufacturer:
~
GUARDIAN
FIBERGLASS INSULATION
1000 East North Slreel Albion, MI 49224
11
~~
MAXIMUM MINIMUM INITIAL MINIMUM
COVEIlAQE DENSITY D5NSITY INSTALLED SETTLED
PER BAG ""-.... '" ,... PC,", THICKNESS THICKNESS
$CIu.f\E FEET {nteKES) {lNCKElil
R-BO 34-9 29 1.141 0.B80 20.75 20.75
R-49 26.' 37 0.887 0.617 17.25 17.25
R-44 23.8 42 0.787 0.60!! 15.50 15.50
::~: ~~ :~ ~::: ~:: 1~~~: 1~~~ !
R-26 13.3 75 0.438 0.546 9.625 9.625
R-22 10.9 0.360 0.516 8.375 B.375
R-19 9.2 0 0.303 0.493 7.375 7.375
R-13 6.S 0.207 OA9 5.00 5.00
R-ll 6.S 1 0 0.173 0.489 '.25 4.25
. ~ m,,;Ul~ res;isl.!!.ncelo heal flow. The highe' tno R""~lJe, Itte gr~aHlrtM Insulatlnll pow~: Ask your teller lotthfll&Ct sheet Of! R-VQtU8S, ~
"'. B~~ Weignt no~lnal:i!.:;l LBS., mlnLmum 30 lflS. For OO&l,IITI\1tlC appllt:Oltloll only. I'kll far ~lI;pouod ~111;II110fl~.ln&l.IIio.ll(>1'l $hould nCiI bellnstallecl a~r ellVel
venl~ Tf.e...,..t\l r,,$iStlll.~4' v~uu IlrlildliltolrrnJnQ<:! ~
i ,.".",,,"",, wlthAS""C,,' ~d"'TMC"'. "'10 ,n,,""" m",,,,,.,,."''''' """"m....OIASTM C76'''po '0"",', 1. I
Type (CheCk appropriate box) R-value Thickness No. Pkgs. COA~~:ge j
R.VALUI!-
BAGS ""
1.o01llFT'
,
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Ii
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Ii
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F
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Kraft UnlBced Foil F5-25 Loose-FIII
Ceilings 0 0 0 0 ~ ::SPl i.L)
0 0 0 0 0
Floors 0 0 0 0
0 0 0 0
Walls 0 0 0 0
0 0 0 0
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Builder's and Applic~tor's Certification Signature
1 This is to certify the insulation as installed conforms to the requirements indicated on this card to provide thermal
resistance value of R..1i- using ..1l- bags of insulation to cover 8 ;. If square feet area.
Depth of previous insulation~. R...1.l.... Type of insulation; f.W AJ OUpgrade ew Construction
,~ Inches A-value Min~lberglas8, Ere,
, ~e II /):::;; 'JJUUc57f'lCi\:>- i.LC ~ '2j--.u.s~
~ Date Company Name (Builder) Mdress E Bliilder's SlgnalUre
5 I!I 1\ Lowes Weatherization P.O. Box 21337 Eu ene OR. 541-485-2282
Del CompQI'lY Name (Apptic;alOI') Atldreas 97402 Phone Applil;:a.tor':; Sign."tu~
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G~t.l1::!O 03109 F'tinr:lild 11'1 U.S.A.
(0 Cluamlan 6ulldll19 PrOOlJctS. Int.