Report Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 1 °- MRt , am the general contractor or the owner-builder
at the following address:
Site Address: ( La g C2 2, R.,004.44-A4?-0-J ( L
City: h b
Permit#: ricer 001001
Subdivision/Lot#: R 5,4 I,0..r L-
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: 44("Z Date: i Z
General Contractor or Owner-Bur
I:\Building\Fonn\RES-MoisaveSensitiveWood.doc 09/25/08
• Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, 1 6--van2 Cr i s'#U' , am the general contractor or the owner-builder
at the following address:
Site Address: (Q se, 51,0Al .Li pC � L t
City: (I iU
Permit#: MST 102, I —001 Da(
Subdivision/Lot#: g p ife it L.,c r 5 ri
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:
ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
1:9Joints lapped 12"at seams and
xtending up the foundation walls 12".
//d/
Signature: i /�'��Z G� Date: 2- z-S 2-
General Con to� Bnier,._.
I:\Building\Form1RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: m' Z-o211 _ 0 01 0 c Jurisdiction: --it /et o
Site Address: HI a a L ' gdoC 17.. / _ /
Subdivision/Lot#: R ff614,
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 Ni 107.2)1
Signature: JeOrrt/b/ Date: L 2- 12'2'
Owner/Gen Contractor/Authorized A t
Print Name: c'4 r�3 8r " —/
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
Form 640S 2017
Completion Certification—Site Inspection yew
New Homes Program—Single Family .„„ r^ �F �i ,
y 3 a
t:f 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 Com
Affordable Housing No
Solar Ready Builder Incentive, No !Solar ReadyVerifier Inc4No
Site Information
Development 4 EASIRIDGE Li 237 Axis ID: !REM/Rate0 ID:
Address: 16882 SW ROCKHAMPTON Lft _ mm I w—
Street Line 2 Multi-Family 'No 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: NW Natural Gas
Solar installed None Solar Installer Name/Company:
Blue shaded fields are required for EPS sheet
Verification Type Actual Model Equipment Details 8 Notes
Slab Perimeter Insulation R- Slab Under Insulation R-
Framed Floor R- 30.0 SecondaryFramed Floor R-
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:10.3 Total window area:
Cooling Air Conditioning SEER 0 Model#:
Primary Heating System Details AFUE: Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH09OXE48C-51
Heating Fuel: Gas SEER.
Primary Heat
Source Comment: COP:
Location: 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-66N 130
Water Healing Fuel Electric Location: 'Garage or ope AHRI Certificate:
Ducts and Duct Location 'Partial %ducts inside: 1a r °I Duct Leakage(CFM)@ 50Pa: 1153 a
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 3.28 I
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWh/yr 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 Showerhead 1.75 GPH I
Notes: