Report (3) Oregon Residential Specialty Code 11318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, �,�yt 4 , am the general contractor or the owner-builder
at the following address:
Site Address: it.//5---6 /(,5--
City: j ,'V _ .
Permit#: MA S 7,0 al - Dov,Q
Subdivision/Lot#: I / lid
4 A 1
166 190
0
./,
and/or V
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: ti^ i —2,2,,
Gene v • .rontrac 0. -Builder
..di joi
1:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Y44 9\0011 _ _V c/O Jurisdiction: Two)
Site Address: y
Subdivision/Lot#: �✓ 11( A01
and/or
Map and Tax Lot#:
By my signature below, I certify that a minimum of fifty(50)percent of the permanently
installed lig sting 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: ��� I� Date: _ LI-Iq-2 2
O 'er' e 4.07 6ITT. for/Authorized Agent
Print Name: Lp
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.
L:\Building\Fonns\RGS-HigliFfficiencyl.ighting.doc 0 7/01/08
•
Oregon Residential Specialty Code 11408
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, (,0 , am the general contractor or the owner-builder
at the following address: f�
Site Address: qi t,
City:
Permit#: — c c 2
Subdivision/Lot#: I -'2 _'
I
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:
L. The ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
71 Joints lapped 12" at seams and
Y 'Extending up the foundation walls 12".
Signature: _ Date: q - lq-3,2
General Con•a t -'Alder
I:\Boilduig\lorniR1.;-MoisnueBanrier.doc 09/13/2016
•
Form 640S 2017
Completion Certification—Site Inspection
New Homes Program—Single Family n Y�^e Truet
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? INo
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 IncelNo
Site Information
Development RI 4 LAS RIDGE II MED Axis ID: RM/Ralemt ID. _
Address. 14156 SW 165TH AVE.
Street Line 2 Multi-Farnlly INo City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.): 1,726 House Volume: ' 15,471 Housing Type: Townhouse inside
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- 59.0
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: 95 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: No Model#-. '
AHRI Certificate:4805339 #of Systems .11
Gallons: 165 Brand: BradfordWhite
Water Heater Type Storage EF: 13.4 Model#: RE250T6-1NCWW
Water Heating Fuel Electric Location, 'Garage or ope AHRI Certificate,9952297
Ducts and Duct Location 'PaSial %ducts inside '; �'Duct Leakage(CFM)@ 50Pa: 1116
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 5.91 I
Ventilation Type HRV/ERV Model
Ventilation
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWldyr Model:
ENERGY STAR Diswasher kWNyr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH J Showerhead 1.6 GPH I 'Showerhead 1.75 GPH '
Notes: