Report Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: r "'Si--d()pt) 003CO Jurisdiction: 1 (
Site Address: /3°13 KG s� Pt ,
Subdivision/Lot#: 121-41,2
and/or
Ma and Tax Lot#: 9
p !.d 7�- 7
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: 2 k Date: � a 1� �w2`/
Owner/General Contractor/Authorized Agent
Print Name:
1 ORSC Section N 1107.2. 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 Efficiency L ightingAcknowledgement_022018
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, , am the general contractor or the owner-builder
at the following address:
Site Address: ( 3 013 LA-4 tuo0D P(r,
City:
Permit#: Y 37- 0(2-0 — co�e,0
Subdivision/Lot#: ra cam' 4
and/or
Map and Tax Lot#: 'f— -1- e;
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
JAI/Joints lapped 12 inches at seams and
Extending up the foundation walls 12 inches.
1-a
Signature: Date:
General Contractor or Owner-Builder
I:\Building\Form\RE S-MoistureBarrierAcknowledgement_022018
•
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, --Rc, , am the general contractor or the owner-builder
at the following address:
Site Address: ( 3 a/3 ,, Tp Pt,
City: � ick
Permit#: S r g0 _ 003 00
Subdivision/Lot#: ke -fief(ace__ 4-6
and/or
Map and Tax Lot#: L,o`r- a7 4
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.
Signature:
�" ')%4) Date: /�` 902/
General Contractor or Owner-Builder
1:1Build ing\Form\RE S-MoistureContentAcknowledgement_022018
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•
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Form 640S 2017
Completion Certification—Site Inspection
New Homes Program—Single Family ' ., Trust
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 Corn
Affordable Housing No
Solar Ready Builder Incentive: No ISolar ReadyVerifier Ince1No
Site Information
Development: RI 15 EASIRIDGE MEl7 Lot 1279 Axis ID: IREMIRate®ID:
Address: 13013 LARKWOODPL. _
Street Line 2 Multi-Family No City: SHERWOOD State: OREGON Zip: 97140
Total conditioned area(sq.ft.): 2,816 House Volume: J 28,441 Housing Type: Detached single family
Number of Stories: 12 Number of Bedrooms: 4 Foundation Type: Crawlspace
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 Details&Notes
Slab Perimeter Insulation R- Slab Under Insulation R-
Insulation Framed Floor R- 30.0 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 SHUC 10.3 Total window area:
Cooling Air Conditioning SEER: 0 Model#:
• Primary Heating System Details AFUE: Brand Lennox
Type: Gas Furnace HSPF: Model 4: ML196UH070XE489-51
Heating Fuel: Gas SEER:
Primary Heat
Comment: COP:
Source
Location: Attic Outdoor Unit(for heat pumps)
ECM: Model#: I
#of Systems 11
Gallons: I Brand: AOSmith
Water Heater Type Heat Pump EF: I Model#: HPTU-66CTA 130 _
Water Heating Fuel Electric Location: [Garage or ope
Ducts and Duct Location 'Partial %ducts inside: Duct Leakage(CFM)@ 50Pa: [157
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.07
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWtdyr Model:
ENERGY STAR Diswasher kWh/yr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I I Showerhead 1.6 GPH I IShowerhead 1.75 GPH ,
Notes: