Report Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
H �- 52TK/ , am the general contractor or the owner-builder
at the following address:
Site Address: I 4 2- 1 S
City: ��
Permit#: M eD'T 2-D 2-I - O D 1 DO
SubdivisionlLot#: � e, A a L c i I (32- 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.
Signature: Date:
General Contractor or Owner-Builder
I:\Buiiding\Form\RES-MoistureSensitiveWood.doc 09/25/08
•f
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: M W ZD 2 I - Do ( nD Jurisdiction: ' I l Fre.,b,
Site Address: , 4' 8 I Pr
Subdivision/Lot#: k- .T I LQ a
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
Si afore: &//Z/
1/ !�-� Date: 2 L-
er/General C ctor/Au orized Agent
Print Name: CJ 7°
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.
1:\Buildingw'orms\RES-HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, r;,rim M trizi24S-kL , am the general contractor or the owner-builder
at the following address: �/
Site Address: ( 5 / (\)/Z
City: 1 LI A icei)
Permit#: M Z 0 Z, I OD I 0-0
Subdivision/Lot#: .b L v T ( (� U
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:
I "I j ne ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
[19.loints lapped 12"at seams and
[ending up the foundation walls 12".
l8/ZZ-
Signature: Date:
General Contractor or Owner- r
I:\Building\Form\RES-MoistureBarrier.doc 09/13/2016
Form 640S 2017
Completion Certification—Site Inspection '" " ,,,ust
New Homes Program-Single Family
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 ISolar ReadyVerifier Ind No
Site Information
Development: RT 4-AS I RIDGL II Mtn It of j166 - Axis ID: I REM/Rate®ID:
Address 14218 atfY 165TH AVE
Street Line 2 Multi-Family -INo City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.): 2,929 House Volume: � 29,581 Housing Type: Detached single family
Number of Stories. 11 Number of Bedrooms: 4 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 8 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 1510
Cooling Air Conditioning SEER. 0 Model#:
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace i HSPF: Model it ML196UH070XE36B-52
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
Location: Conditioned A Outdoor Unit(for heat pumps)
ECM: No Model#: I
AHRI Certificate:4805339 #of Systems 11
Gallons. I Brand: AOSmith
Water Heater Type Heat Pump EF: I Model#: HPTU-80N 130
Water Healing Fuel Electric Location' 'Garage or ope
Ducts and Duct Location 'Partial %ducts inside F°% '.1Ducl Leakage(CFM)@ 50Pa: 1206
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.72 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 kWNyr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%( Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
INotes:
I
i
I
I
1
I
i
Gi
t
1
1
1
t1I
4