Report Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, M a- -1 ! , am the general contractor or the owner-builder
at the following address:
Site Address: I L Le 8 3
City: f &O
Permit#: n 2_0 2 ( _
Subdivision/Lot#: 401446- L)'(— 1 rj
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:
e 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:
neral Contractor o wner-Builder
I:1Buiiding\Form'.RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: M 'r Z O Z ( ,001/- Jurisdiction: 1 -
Site Address: I LctC B 6- kt w I tt
Subdivision/Lot#: ' L- r,-- 1 5-8
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
/Z
Signature: 7/" Date:
caner/Gene Contractor/Authorized Age
6 G/L-
Print Name: 1,,7�/S
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.doe 07/01/08
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 4-'/C_v72 06-gzlciov(/ , am the general contractor or the owner-builder
at the following address:
Site Address: I L l_ie UDOlk ? a_ ,1 o 5 o f
City: LvicK2-CO
Permit#: M 2-D 2- ( -- DO 2_-(Q L-
Subdivision/Lot#: 614eAL. LOT- / 5-8
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.
//1
Signature: � Date: Z
enerai Contractor r or 0
1:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Form 640S 2017
Completion Certification—Site Inspection New Homes Program—Single Family e (: Tr us
t
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?: INS
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 ISolar ReadyVerifier IncsiNo
Site Information
Development RI 4 EASTRIDGE II MED I.o! 1158 Axis ID: I (REM/Raley ID.
Address: 16663 SW.TOWNSVILLE ST
Street Line 2 Muni-FanGly Lo City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.). 3,150 House Volume [ 31,500 Housing Type: Detached single family
Number of Stories: 13 Number of Bedrooms: 5 Foundation Type: Crawlspace
Electric Provider: Portland General Electric Gas Provider: INW 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- 0.0 Slab Under Insulation R-
Framed Floor R- 30.0 Secondary Framed Floor R- 59.0
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. 1470
Cooling Air Conditioning SEER: 0 Model 9:
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model 4: ML196UH070XE36B-52
Heating Fuel: Gas SEER
Primary Heat
Source Comment: COP:
Location: Attic Outdoor Unit(for heat pumps)
ECM: No Model 9: '
AHRI Certificate:4805339 8 of Systems 11
Gallons: 166 Brand: AOSmith
Water Heater Type Storage EF: 13.17 Model II: HPTU-66N 130
Water Heating Fuel Gas Location: 'Garage or ope AHRI Certificate:
Ducts and Duct Location 'Partial %ducts inside 150% ''Duct Leakage(CFM)@ 50Pa:
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.52 '
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWNyr Model.
ENERGY STAR Diswasher kWh/yr Model:
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwend 1.5 GPH ' Showerhead 1.6 GPH I 'Showerhead 1.75 GPH I
Notes: