Report Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: IAA Jurisdiction:
Site Address: / /) (� 301 Lk-7794) / , /
di of#:
and/or
Map and Taxil,,.ot Jj
By my signature below, I certify that all of the permanently installed lighting fixtures in the
above mentioned building contain high-efficacy lamps. Screw-in compact fluorescent and LED
lamps comply with this requirement. (Oregon Residential Specialty Code N1107.2)1
Signature: J 114)/ Date: J 21
Owner/General Contractor/Authorized Agent
Print Name: TI
ORSC Section N1107.2. High-efficacy lamps. All permanently installed lighting fixtures shall contain high-
efficacy lamps. Screw-in compact fluorescent and LED lamps comply with this requirement.
The building official shall be notified in writing at the final inspection that the permanently installed lighting fixtures
have met this requirement.
Exception: Two permanently installed lighting fixtures are not required to have high-efficacy lamps.
I:\Building\Forms\RES-High EfficiencyLightingAcknowledgement_022018
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
�'42T , am the general contractor or the owner-builder
at the following address:
Site Address: (clq S
City:
Permit#: j 9o;-0
ti bdivision/ t#: S �
and/or
Map and Ta Lot
d J /.
To conform with the 2017 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 by a Class I vapor retarder or
other approved materials, with
Joints lapped 12 inches at seams and
Extending up the foundation walls 12 inches.
Signature:
�c- m Date: i - ,�
General Contractor or Owner-Builder
I:\Building\Form\RES-MoistureBarrierAcknowledgement_022018
Oregon Residential Specialty Code R318.2
{@9
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, , , am the general contractor or the owner-builder
at the following address:
Site Address: ( c84,c144,14,,,,./ LA'
City:
Permit#: rA. J_T,_- ,- - ? f
aivsio Lot#: (12_ L L
and/or
Map and Tax ? cif
To conform with the 2017 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.
��--� 9 f- 2i
Signature: � Date:
eneral Contractor or Owner-Builder
l:\Building\Form\RE S-Moi stureContentAcknowl edgement_022018
.
Form 640S 2017 ,
Completion Certification—Site Inspection no.rp-vTrust
New Homes Program—Single Family
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 Ile this payment redirected? INo
Builder or Company: Polygon Northwest-WA Redirect to Name:
Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Corn
Affordable Housing No
Solar Ready Builder Incentive: No (Solar Ready Verifier Inc[No
Sits Information
Development: RT 4 EASTRIDGE II MED Lot `\1 Axis ID: REM/Rate®ID.
Address: 11211=1222=MarMantiliraeigtaIkger,
Street Line 2 Multi-Family No City: TIGARD State: OREGO Zip. 97224
Total conditioned area(sq.ft.): 2,375 House Volume: I 23,987 Housing Type: Detached single family
Number of Stories: 12 Number of Bedrooms. 3 Foundation Type: Crawlspace
Electric Provider: 'Portland General Electric Gas Provider: lNW 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-
Framed Floor R- 30.0 Secondary Framed Floor R- 59.0
Insulation
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:'0.3 Total window area. 1420
Cooling Air Conditioning SEER 0 Model#: ML14XC1S030-230A05
Primary Heating System Details AFUE. 95 Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH045XE36B-51
Heating Fuel: Gas SEER.
Primary Heat Comment COP:
Source
Location: Attic Outdoor Unit(for heat pumps)
ECM. No Model#:
AHRI Certificate:4805339 #of Systems 11
Gallons: 166 Brand: AOSmith
Water Heater Type Storage EF: 13.17 Model it: HPTU-66N 130
Water Heating Fuel Gas Location: [Garage or ope AHRI Certificate:
Ducts and Duct Location IPartial %ducts inside: i AC.Duct Leakage(CFM)@ 50Pa M.. r7",ti,"r"Er
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.5 I
Ventilation
Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? IRoof Termination
Appliances
Refrigerator kWh/yr 613 Model. GYE22GYNFFS
ENERGY STAR Diswasher kwhryr Model: GDF51OPSROSS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
Notes: