Report Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: MT oz., _ 00( 39 Jurisdiction:
Site Address: j (ai i el 3,1,0 d ,,l a(tot/iy Cy r
Subdivision/Lot#: 14&RAD
and/or
Map and Tax Lot#: / //b
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
Signature: ,611eZ_ Date: ®2-//3/ ZO
/General actor/Authorized Agent
Print Name: Cf l d Tr GiL 1ef igz ,
'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
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, 7/t a 46-al , am the general contractor or the owner-builder
at the following address:
Site Address: I Lt 49 'w gr..
City: %1 Pg4)
Permit#: Pl 5 202,I - 0013 g
Subdivision/Lot#:
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:
1-9 The ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
in
L gJoints lapped 12"at seams and
xtending up the foundation walls 12".
Signature: C / Date: /Z// 3/ Z/
General Contract or Owner-Builder
I:\Building\Form\RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
/ "9 L02 Mom / , am the general contractor or the owner-builder
at the following address:
Site Address: /& 7FiA) . / ,,t/� ('64Sr �.
City: / 7 4-i ,
Permit#: I1yf �oZ1 — DO / 9
Subdivision/Lot#: / O
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: Date: Z 3 Z
eneral on r or Owner-Build
I:\BuildingWorm\RES-MoistureSensitiveWood.doc 09/25/08
T)
Form 640S 2017 ..
Completion Certification—Site Inspection
t
New Homes Program—Single Family ^°^ TrC 4y. "'a e" "^"'
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?: No
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 Inc4No
Site Information
Development' 4 EAS IRIDGE Lof I140 Axis ID: 'REM/Rate®ID.
Address: 16647 SW SUNSHINE COAST ST
Street Line 2 Mutti.Family INo City. TIGARD State: OR Zip: 97224
Total conditioned area(sq.ft.). 2,703 House Volume. 25,635 Housing Type: Detached single family
Number of Stories: 12 Number of Bedrooms: 3 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 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#: ML196UH070XE48B-51
Heating Fuel: Gas SEER:
Primary Heat
Source Comment COP:
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: 'S(#% IDuct Leakage(CFM)@ 50Pa. 1167
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.12
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances —
Refrigerator kWlvyr Model:
ENERGY STAR Diswasher kWhlyr Model. GDF510PSR3SS _
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I I Showerhead 1.6 GPH I IShowerhead 1.75 GPH
Notes: