Report Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, L.U1Q G q , am the general contractor or the owner-builder
at the following address:
Site Address: q 2 u 7i -
City %���
Permit#: 5T ZoZ I - Dv l c3
Subdivision/Lot#: No 6eAt_ 17 D
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: G� Date: f /Z2
General Contractor or Owner-Builder
I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, iy t vi.. J—' peZ2 1 kirk! , am the general contractor or the owner-builder
at the following address:
Site Address: 14 lb 2 ' c r
if
City: �� N A1%0
Permit#: N Sl ZDZ I - DO I S3
Subdivision/Lot#: p LD-r I '1 C
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:
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".
6// Z�
Signature: ��%/� Date:
General Contractor or Owner-Builder
I:\I3uiIdingworm\RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: M �- IO2,1 _ OD ( 53 Jurisdiction: / h
rrit
Site Address: / Z / it
Subdivision/Lot#: po,i,/eL &b T / 17D
and/or a'�
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
Signature: S.947& \ Date: b 17/2er/General Contractor/Authoriz ent
Print Name: St'7T L(�-T
'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:\BuildingTonns\RES-HighEfficiencyLighting.doc 07/01/08
Form 640S 2017
1'
Completion Certification—Site Inspection *
New Homes Program—Single Family , " #S ergyT "
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: 1Polygon 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 Inc4No
Site Information
Development: R1 4 IAS I RIDGE II Mkt) _t of J170 Axis ID: I I REM/Rate®ID:
Address: 14262 SW 165TH AVE
Street Line 2 Mini-Family INo City: TIGARD State: OREGOP Zip: 97224
Total conditioned area(sq.ft.): 3,911 House Volume: I 40,466 Housing Type: Detached single family
Number of Stories: 11 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-
Framed Floor R- 30 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:I0.3 Total window area: I
Cooling Air Conditioning SEER: 0 Model#: 13ACXN048-230-22
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model#: ML296UH110XV60C-58
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
1 Gallons: I Brand: AOSmith
Water Heater Type Heat Pump EF: I Model#: HPTU-80N 130
Water Heating Fuel Electric Location:LGarage or ope
Ducts and Duct Location I Partial %ducts inside: ir1 Al Duct Leakage(CFM)@ 50Pa: 1211
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.04 I
_.
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? I Roof Termination
Appliances
Refrigerator kWi/yr Model:
ENERGY STAR Diswasher kWh/yr 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
Notes: