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Oregon Residential Specialty Code R408.1 MOISTURE BARRIER ACKNOWLEDGEMENT FORM I, ryi-y L , N"(c 4 , am the general contractor or the owner-builder at the following address: Site Address: (�(QOt 9,1,0 U w lgoiLLE '� City: 0441 D Permit#: M�'T` 2_o 2-1 bb 2ct Subdivision/Lot#: (Ko L©i 2.-i 1 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: he ground surface of the under-floor space is covered with 6-mil black polyethylene sheeting with Joints lapped 12"at seams and Extending up the foundation walls 12". d-///Y /1/- Signature: Date: eneral Contractor or Owner-Builder I:1Building\Form\RES-MoistureBarrier.doc 09/13/2016 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, iY M t 1 kerk , am the general contractor or the owner-builder at the following address: Site Address: �a 0 ') r o- wi i4. City: r'1 L-4Z Permit#: M 1,02-I _ c0139 Subdivision/Lot#: g bcc46ei(.- tri L I CI 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: _ r 6 Date: 117?/ eneral Contractor or Owner- ilder I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 2 2 ( , 00239 Jurisdiction: T1E.0.12.0 Site Address: /0 Le Ol 0 < rA�a'(� 9- Subdivision/Lot#: R c64.t 044_ LD°r 2-1 - 1 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 46- Signature: Date: Owner/General Contrac nze gent 5)6617— Print Name: v �-�J 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:\Building\Forms\RES-HighEfficiencyLighting.doc 07/01/08 Form 640S 2017 Completion Certification—Site Inspection �w '" New Homes Program—Single Family E. T# ust 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 IncdNo Site Information Development. 4 I:AS(RIDGE Lot.' � 219 Axis ID: IREM/Rat00 ID: Address: 16690 SW'row NSVILLE ST ��, Street Line 2 Multi-Family INo 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: 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- 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: I Cooling Air Conditioning SEER: ,0 Model it. 13ACXN036-230-23 Primary Heating System Details AFUE: Brand Lennox Type: Gas Furnace HSPF: Model#: ML196UH09SXE48C-51 Heating Fuel: Gas SEER: Primary Heat Source Comment COP: Location: Attic Outdoor Unit(for heat pumps) ECM: Model#: I #of Systems 11 Gallons: I Brand: AOSmith Water Heater Type Heat Pump EF: I Model#: HPTU-80N 130 Water Heating Fuel Electric Location, (Garage or ope Ducts and Duct Location (Partial %ducts inside: l, Duct Leakage(CFM)@ 50Pa. I185 Testing Infiltration Air Changes per Hour(ACH)@ 50Pa. 2.59 Ventilation Ventilation Type H l.RV/ERV Mode Supply Side-Air Cycler Airflow measured or why untestable? !Roof Termination Appliances Refrigerator kwivyr Model. ENERGY STAR Diswasher kwlvyr Model: GE Percent High Efficacy Interior Lighting(%) Thermostat Showerhead 1.5 OPH I I Showerhead 1.6 GPH I (Showerhead 1.75 GPH I Notes: