Report Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: C'1l Za1 , 3 3 Jurisdiction: i 14-7 1J
Site Address: , alit) —Dow,fro l / Q
Subdivision/Lot#: ` / + 3/40
and/or J
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
Signature: / Date: Z
Owner/General Co�I/Authoriz gent
Print Name: SCE e L ,tcm /
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
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, I il-7 ce t t3 , am the general contractor or the owner-builder
at the following address:
Site Address: ( Li 1 I 0 C„0 1 (thiJ L,o P
City: 1 1 oii-
Permit#: M ` 7T 20 j-t - 00 18 3
subdivision/Lot#: R 0 ( 8 j
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: jDate:
eneral Contract6r or Owner-Builder 21 / / 2"7—
I:\13uilding\Formu2ES-MoistureSensidveWood.doc 09/25/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, ` rA-Vice M v-024 km/ , am the general contractor or the owner-builder
at the following address:
Site Address: ILA 1 0 DA l(/ L 0D p
City:
Permit#: MSTD 7 - 00183
Subdivision/Lot#: pt_
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
xtending up the foundation walls 12".
Signature: �4. f Date: 2- --
S
Contrac or Owner-Builder _ __..._
I:\Building\Form RES-MoistureBarrier.doc 09/13/2016
Form 640S 2017
Completion Certification—Site Inspection
rustNew Homes Program—Single Family •r
Of 01 E'tJofi
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 Com
Affordable Housing No
Solar Ready Builder Incentive: No (Solar ReadyVerifier IncrNo
Site Information
Development 4 EASI RIDGE I J1196 Axis ID. I IREM/Rater&ID:
Address. 16710 SW DARWIN LOOP
Street Line 2 Muth Family No City: TIGARD State: OR Zip 97224
Total conditioned area(sq.ft.): 1,293 House Volume: J 11,766 Housing Type: Detached single family
Number of Stories: 11 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.
AboveGrade 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 9:
Primary Heating System Details AFUE: Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH045XE36B-51
Heating Fuel: Gas SEER:
Primary Heat
Source Comment COP:
Location: Attic Outdoor Unit(for heat pumps)
ECM: Model#: '
#of Systems 11
Gallons: 165 Brand: BradfordWhite
Water Heater Type Storage EF: 13.4 Model#: RE250T6-1NCWW
Water Heating Fuel Gas Location: 'Garage or ope AHRI Certificate:9952297
Ducts and Duct Location (Partial %ducts inside. [6% Duct Leakage(CFM)@ 50Pa: 1107
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa. 3.47 I
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appilsnc.s
Refrigerator kWluyr 613 Model: GYE22GYNGFS
ENERGY STAR Diswasher kWh/yr Model: GDF535PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I j Showerhead 1.6 GPH I (Showerhead 1.75 GPH I
Hateat