Report Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, / i-V Oi I o72 s/( , am the general contractor or the owner-builder
at the following address:
Site Address: (e'7 oc 5 j /,j (? .7 --
City: l 64 0 OIL( C r72-1 3
Permit#: el - Zo z-I - 00664
Subdivision/Lot#: ' 3 4, j`�. �
and/or ��
Map and Tax Lot#:
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
1 ending up the foundation walls 12".
//�Z1Date: 9 ZI /
Signature: C�
General Contractor or Owner-Buil
I:1BuildingiFonn\RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: r .7.-i p 2_ 1 _ °DO 6-L[Jurisdiction:
Site Address: 1 ce,10 5 vAi s„/`Loc £ 6 s —
Subdivision/Lot#: 1 3t..4, Ro 514 r L
and/or
Map and Tax Lot#:
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 N1107.2)1
2
•
Signature: ,-- z''£--7--- -`.._--- g/t J/��
Date:
/
Owner/General ContractgtLAutho - ed Agent
Print Name: J ii L/Lr.!144.1 e 7
-2.56
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:\Buiiding\Forms\RES-HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
L • irekyti'0.... /167042/-sev,./ , am the general contractor or the owner-builder
at the following address:
Site Address: "
City: - V1,, 2) i644
Permit#: M - z o A (YDO 4
Subdivision/Lot#: •.3� R 0514 A-
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.
7Signature: C� ` --_.... Date: 9 1
General Contractor wner-Builder
1:113uildingWormlRES-MoistureSensitiveWood.doc 09/25/08
Form 640S 2017
Completion Certification—Site Inspection
LnervTrust
New Homes Program—Single Family „
of Oregon.
To be completed by Verifier
CLEAResuft 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 ISolar ReadyVerifier InceiNo
Site Information
Development. 4 EAST RIDGE Lot I136 'Axis ID: I (REM/Rate®ID:
Address: 16705 SW SUNSHINE COAST ST
Street Line 2 Multi Family INo City: TIGARD State: OR Zip: 97224
Total conditioned area(sq.ft.): 2,703 House Volume: I 25,635 Housing Type: Detached single family
Number of Stories: 12 Number of Bedrooms: 4 Foundation Type: Crawlspace
Electric Provider: Portland General Electric Gas Provider: INW 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- Slab Under Insulation R-
Insulation Framed Floor R- 30 Secondary Framed Floor R-
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: '
Cooling Air Conditioning SEER: 0 Model#: ML14XC1S036-230C08
Primary Heating System Details AFUE: Brand Lennox
Type: Gas Fumace HSPF: Model#: ML196UH070XE36B-52
Heating Fuel: Gas SEER:
' Primary Heat
Source Comment: COP:
Loca0on: Attic Outdoor Unit(for heat pumps)
ECM: Model#: I
#of Systems 11
Gallons: 166 Brand: AOSmith
Water Heater Type Heat Pump EF: 13.17 Model#: HPTU-80CTA 130
Water Heating Fuel Electric Location: 'Garage or ope ARID Certificate:
Ducts and Duct Location 'Partial %ducts inside: I50% 'Duct Leakage(CFM)@ 50Pa: 1109
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.73 I
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? (Roof Termination
Appliances
Refrigerator KWhiyr Model:
ENERGY STAR Diswasher kWhyr Model: GDF510PSROSS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
Notes: