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Oregon Residential Specialty Code R408.1 MOISTURE BARRIER ACKNOWLEDGEMENT FORM 170140a0-0v4se-r-- , am the general contractor or the owner-builder at the following address: Site Address: 13 v Q 51,J 16 k/ City: Permit#: V\ASC ‘cl - ©D 3a_6 Subdivision/Lot#: \V-2J2„f A 3 and/or Map and Tax Lot#: 1.01— �01- 1 To conform with the 2014 Oregon Residential Specialty Code (ORSC), Section R408.1 Ventilation. I am notifying the building official that I have installed the Moisture Barrier as per Requirement in ORSC Section 408.1 and have taken the following steps to meet this code requirement: (-The ground surface of the under-floor space is covered with 6-mil black polyethylene sheeting with L'J Joints lapped 12"at seams and r7xtending up the foundation walls 12". Signature: 74 Date: Ca- 17- 0?-0 General Contractor or Owner-Builder I:\Building\Form1RES-MoistureBarrier.doc 09/13/2016 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, ICE Gt r I�vJ� , am the general contractor or the owner-builder at the following address: Site Address: 30,20 lJ C 6 5 -- j-t) City: Permit#: ?C' `� _003 l Subdivision/Lot#: 41e r T'c:— A 3 and/or Map and Tax Lot#: To conform with the 2008 Oregon Residential Specialty Code(ORSC), Section R318.2 and OAR 918-480-0140, 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]. R318.2 Moisture Content: Prior to the installation of interior finishes,the building official shall be notified in writing by the general contractor that all moisture-sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: _ 1 Date: I p - 17-07 D 20 General Contractor or Owner-Builder I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: ►MS � 2-o�q — Oo3�l Site Address: 13 Pa 0 s(/" (�i / 1) Subdivision/Lot#: 3 and/or Map and Tax Lot#: 4+ v 63 By my signature below, I certify that a minimum of fifty(50)percent of the pennanently 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 Signature: W1-0 Date: 0? - O?O Owner/General Contractor/Authorized Agent Print Name: 1210 +- CAD ' ORSC Section N1107.2.High-efficiency interior lighting systems. A minimum of fifty(50)percent o the permanently installed lighting fixtures 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 fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent,or a minimum efficacy of 40 lumens per input watt. I:\Building\Forms\RES-HighEfficiencyLighting.doc 07/01/08 ...... ........ ........................................................................-...........,... ............ :........ .. ......:.. •.e.«:vr.x n.«.reerrr x xrsrx o ar arVrues.,ar r.of.•+ e..t r.+rrt.€ x +.. it teP.. P S.t it1 tf N h.€ttV.my e, .fnt±f»t.t trV.t Form 640S 2017 Completion Certification—Site Inspection t New Homes Program-Single Family �" � *s* of Oregon To be completed by Verifier CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc. Payment information Incentive Payee Company Name 'Polygon Northwest-WA Its this payment redirected?: INo Builder or Company Polygon Northwest-WA Redirect to Name. Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Com( Affordable Housing No Solar Ready Builder Incentive No 'Solar ReadyVerifier IncelNo Site Information Development NE River-Area 3-Med/Std Lot 1229 Axis ID: 1 'REM/Rate®ID Address 13220 SW 165th Ave -,1,41111 Street Line 2 Multi-Family INo City. Sherwood State OR Zip 97140 Total conditioned area(sq.ft.). 2,594 House Volume 1 27,000 Housing Type. Detached single family Number of Stories 11 Number of Bedrooms. 4 Foundation Type Crawlspace Electric Provider Portland General Electnc Gas Provider: NW Natural Gas Solar installed None Solar Installer Name/Company: Blue shaded fields are required for EPS sheet Verification Type Actual Model Equipment Details&Notes Slab Perimeter Insulation R- 0.0 Slab Under Insulation R- Insulation Framed Floor R- 30.0 Secondary Framed Floor R- 59.0 Above Grade Wall Insulation R- 23.0 Below Grade Wall Insulation R- Flat Ceiling Insulation R- 49.0 Vaulted Ceiling Insulation R- Windows Windows U- 0.3 SHGC 10.3 Total window area 1599 Cooling Air Conditioning SEER. Model#: NTXMMX48A182BA Primary Heating System Details AFUE Brand Mitsubishi Type: Electric Heat Pump-Mini Split Non-Ducted HSPF. 13.5 Model# PEAD-A36AA7 Heating Fuel: Electric SEER. 30.5 Primary Heat Source Comment: COP Location Attic Outdoor Unit for heat pumps) ECM. No Model# IMUZ-FHO9NA AHRI Certificate #of Systems 12 Gallons I Brand. AOSmith Water Heater Type Heat Pump EF. I Model#. HPTU-8ON 130 Wafer Heating Fuel Electric Location 'Garage or ape Ducts and Duct Location 'Unconditioned %ducts inside '0% 'Duct Leakage(CFM)@ 50Pa 146 Testing Infiltration Air Changes per Hour(ACH)@ 50Pa. 3.92 Ventilation Ventilation Type HRV/ERV Model'. Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination Appliances Refrigerator kWh/yr Model ENERGY STAR Diswasher kWhlyr 240 Model GDT6***F** Percent High Efficacy Interior Lighting(%) 100% Thermostat Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I