Report Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWL
EDGEMENT FORM
I, P,P JLV+-- , am the general contractor or the owner-builder
at the following address: /
Site Address: ( ( 9� 5 W 72 ct_vt....
City:
Permit#: 144 f i0 p--0 — Qo 3c{
u.divisio. .t#: II0SI.4c-
andlor
Map and T. o ,. �✓ l
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
Joints lapped 12"at seams and
[ xtending up the foundation walls 12".
Signature: 7-214:1- Date: 9-7- ail
General Contractor or Owner-Builder
I:1Building\Form\RES-MoistureBazrier.doc 09/13/2016
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, l jo✓ , am the general contractor or the owner-builder
at the following address:
Site Address: l bqo(,/( 16" eta dC
City:
T5 �
Permit#: - a 0 - 00 3 (4,1
u.divisio t#: SK
and/or I I�
Map and Tax
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: (�y
1 � - 7-
�--� Date: 9
General Contractor or Owner-Builder
I:\Building'Porte\RES-MoimireSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 04
S 2,0 _ o 3(1 Jurisdiction: -77 5
Site Address: / / 90,/ S (( - G ^ ��^7 _ (A./.
Sot#: � S -
and/or /
Map and Tag-,
By my signature below, I certify that a minimum of fifty(50)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 NI 107.2)1
Signature: 72 K s Date: £ - 7 —
Owner/General Contractor/Authorized Agent
Print Name: Tc:.
1 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
Form 640S 2017
Completion Certification—Site Inspection 3" Trust
New Homes Program—Single Family „}
of Oregon
To be completed by Verifier
CLEAResult/s 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 II
Solar Ready Builder Incentive: No (Sohn ReadyVerifier IncgNo
Site Information
Development 4 EAST RIDGE ILO: I239 Axis lD: 1 (REM/Rate®ID'.
Address: 16904 SW ROCKHAMPfON LN
Street Line 2 MUd-Family INo City: TIGARD State: OR Zip: 97224 _
Total conditioned area Isq.ft.): 2,816 House Volume: I 25,238 Housing Type: Detached single famtly
Number of Stories: 12 Number of Bedrooms: 4 Foundation Type: Crawkpace
Electric Provider: Portland General Electric 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 DetelN&Notes
Slab Perimeter Insulation R- Slab Under Insulation R-
Framed Floor R- 30.0 Secondary Framed Floor R-
Insulaeen
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: I
Cooling Air Conditioning SEER: 0 Model®
Primary Heating System Details AFUE: Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH070XE36B51
Heating Fuel: Gas SEER:
Primary Heat Comment: COP:
Source
Location: Conditioned A Outdoor Unit(for heat pumps)
ECM: Model It: I
#of Systems 11
Gallons: lee Brand: AOSmlh
Water Heater Type Storage EF: 13.17 Model#: HPTU-80CTA 130
Water Heating Fuel Electric Location: 'Garage or ope AHRl Certificate:
Ducts and Duct Location IPartial %ducts inside: „VIA Duct Leakage(CFM)®50Pa: 1286
Testing
Infiltration Air Changes per Hour(ACH)d 50Pe: 2.94 I
Ventilation Ventilation Type HRWERV Modal:
Supply Side-Air Cycler Aidlaw measured or why untestable7 'Roof Termination
Appliances
Refrigerator kWtsyr Model.
ENERGY STAR Diswasher kWNyr Model:
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I 1 Showerhead 1.6 GPM I IShowedieao 1.75 GPI( I
Notes: