Report Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 1-01-kitom. 11/44 inaJOAseN , am the general contractor or the owner-builder
at the following address:
Site Address: La 2 q 5__ , t�L
City: 1 1 wvair)
Permit#: '�(� " i02,1 - °b I g
Subdivision/Lot#: /
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: Q!�(.�L / Z //3 /zj Date:
General Contractor or Owner-Builder
I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: m vi--ZQ Z _ co 1 L10 Jurisdiction:
Site Address: I (21 54") 13itt /ti1/6 AQ.II-Pr-
Subdivision/Lot#:
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
Signature: yedez/4.,__ Date: /Zo /3/2-/
Owner/Generi Contractor/Autho d Agent
Print Name: C/ dAfr L/60:61/,
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\Fonns\RES-HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, -reqem2 frtrnrif SrM , am the general contractor or the owner-builder
at the following address:
Site Address: I (ICI Z Gi Frvu �vAf m'l /C e 7 -
City: J 7:t PO
Permit#: I'crj- Lo - DO 14
Subdivision/Lot#: 14 (
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 Bather 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: Date: / ' 3j 7'/
General Contractor Owner-Builder
I:'Building\FormmRES-MoistureBarrier.doc 09/13/2016
iii/
/k/ t. E c '-y/I'. D, � �- E �h k\ ` 1'
pp
J -
N. f „.-
Form 640S 2017 N.
Completion Certification—Site Inspection y �w. y
New Homes Program—Single Family �4t4". I6 ++T 14
of Oregon
To be completed by Verifier
CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment tnformetton
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 Corn
Affordable Housing No
Solar Ready Builder Incentive: No !Solar ReadyVerifier Inc4No
Site Information
Development: 4 EASTRIDGE Lot 11411 rr Axis ID: I [REM/Rate®ID.
Address: �y�,A�L�\* ,k r
Street Line 2 Multi-Family No 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. 4 Foundation Type: Crawlspace
Electric Provider: Portland General Electric Gas Provider: NW Natural Gas
Solar installed None Solar Installer Name/Company:
Slue shaded fields are required for EPS sheet
Verification Type . . Actual Model Equipment Deta0s&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.I0.3 Total window area: I
Cooling Air Conditioning SEER 0 Model#.
Primary Heating System Details AFUE: Brand Lennon
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#:
#of Systems [1
Gallons: 166 Brand: AOSmith
Water Heater Type Heat Pump EF: 13.17 Model#: HPTU-80CTA 130
Water Healing Fuel Electric Location: [Garage or ope AHRI Certificate:
Ducts and Duct Location [Partial %ducts inside: •'r Duct Leakage(CFM)@ 50Pa: anittAfttlitirglAigageka.
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.65 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: GDT645SSN3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I I Showerhead 1.6 GPH I IShowerhead 1.75 GPH
Notes: