Report (3) • Oregon Residential Specialty Code R408.1-
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
1, Rob I(Qe / , am the general contractor or the owner-builder
at the following address:
Site Address: _—I up is !w 70 wN S(Jac r: 5r
City: -�"�&Red
Permit#: (ii 5a0 00'-( '7
Subdivision/Lot#: it/4r r(ice Lof 21 c- pri q cry
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:
nThe ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with.
Joints lapped 12"at seams and
vci Extending up the foundation walls 12".
Signature: Date: — 29,
Gen Contractor or Owner-Builder
1:\BuildingWorm\RES-MoishireHarricr.doc 09/13/2016
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
(oe.hv , am the general contractor or the owner-builder
at the following address:
Site Address: (9`0 'g •
5w Thum 5V LL. 5r
City: T i Gwrd 4 O . _
Permit#: rnsr 20'1 0 0 L1 7
Subdivision/Lot#: Ri v er 1 errA ce. (,01 9 t S
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: 6/2,0 "X9,
neral Contractor or Owner-Builder
1:113uildinaorm\RES-MoistureSensitiveWood.doe 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH—EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 09151" e‘OQ,l _00417 Jurisdiction:
Site Address:
(a, !g 5w 7 OwP5u.uE ST"
Subdivision/Lot#: Rivcr lecrnte
LOT 9,l (eft t"Rry
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 N1107.2)1
Signature: Date: — 9,0`9,2,
Owne eneral Contractor/Authorized Agent
Print Name: 17 oh t`oeh,(i
'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 minimwn 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
2 i
Form 640S 2017
Completion Certification—Site Inspection "
New Homes Program—Single Family a 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 Incp[No
Site Information
Development 4 t:AS 1 RIi1Gl.: ut 215A UPSTAIRS Axis ID. I IREM/Rate®ID.
Address 1661E SW TOWNSVILLE ST
Street Line 2 Multi-Family [N[No City: TIGARD State: OR Zip. 97224
Total conditioned area(sq.ft.), 2,023 House Volume: 1 18.609 Housing Type: Detached single family
Number of Stories' 12 Number of Bedrooms: 4 Foundation Type: Crawlspace
Electric Provider: Portland General Electnc 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- 30.0 Secondary Framed Floor R-
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 SHGQ'0.3 Total window area:
Cooling Air Conditioning SEER. 0 Model#:
Primary Heating System Details AFUE Brand Lennox
Type: Gas Furnace HSPF: Model if. ML196U1-1070XE36B-52
Heating Fuel: Gas SEER.
Primary Heat
Source Comment COP.
Location Attic Outdoor Unit(for heat pumps)
ECM' Model II: I
d of Systems 11
Gallons: 165 Brand: Bradford White
Water Heater Type Storage EF: '3.4 Model#: RE250T6-1NCWW
R Water Healing Fuel Electric Location 'Garage or ope AHRI Certificate'9952297
Ducts and Duct Location IPartial %ducts inside: JDuct Leakage(CFM)@ 50Pa: [158
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa 3.72 I
Ventilation Type HRV/ERV Model.
Ventilation
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWh/yr Model.
ENERGY STAR Diswasher kWh/yr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I I Showerhead 1.6 GPH I I Showerhead 1.75 GPH I
Notes:
t
I
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