Report Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, i / l -i 1 , am the general contractor or the owner-builder
at the following address:
Site Address: I Le u. 2 .)
City:
Permit#: MrZoZ I -O()22 ,
Subdivision/Lot#: ?4 i - ' (--
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.
) ✓ Z
Signature: Date:
/2-
General Contractor o r- udder
I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, 1 yLn2 M tr1.Z(f i , am the general contractor or the owner-builder
at the following address:
Site Address: ` le[4 t OA S L1ILW.W
City: 1-1 ,e b
Permit#: Hc-01" Z02, 1 - pOZZ(P
Subdivision/Lot#: R (-b-r I (e Z
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 'th
Joints lapped 12"at seams and
ending up the foundation walls 12".
PSignature: yz(4,----- Date: 62- 2-General Contracto Owner-
I:\Building\Fonn\RES-MoistureBarrier.doc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: - 7_0 2 , _ 2 Jurisdiction: �� Lln b
Site Address: I I D 0, e-vU La-
Subdivision/Lot#: 2D T- I te.2
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
Signature: Date: /2, Z Z
caner/General ontractor/Authorized
Print Name: J` D7r L-7( c /3z
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
New Homes Program—Single Family e �
of 0 r.o1i on
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 I Is this payment redirected?: 'No
Builder or Company: Polygon Northwest-WA Redirect to Name:
Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Com
Affordable Housing No
Solar Ready Builder Incentive: No (Solar ReadyVerifier Inc4No
Site Information
Development: RT 4 EASTRIDGE is MFD _JLo! 161 Axis ID: I 'REM/Rate®ID:
Address IOW SW TOWNSVILLE ST
Street Line 2 Multi-Family INo City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.): 3,150 House Volume: 1 31,500 Housing Type: •Detached single family
Number of Stories: 13 Number of Bedrooms: 5 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&Notes
Slab Perimeter Insulation R- 0.0 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: 1470
Cooling Air Conditioning SEER: 0 Model#:
Primary Heating System Details AFUE: 95 Brand Lennox
Type: _Gas Furnace HSPF: Model#: ML196UH07OXE36B-52
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
Location: Attic Outdoor Unit(for heat pumps)
ECM: No Model#: I
AHRI Certificate:4805339 #of Systems 11
Gallons: 166 Brand: AOSmith
Water Heater Type Storage EF: 13.17 Model#: HPTU-66N 130
Water Heating Fuel Gas Location: 'Garage or op AHRI Certificate:
Ducts and Duct Location 'Partial %ducts inside: Duct Leakage(CFM)Q 50Pa: '146
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 3.06 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 kWh/yr Model: GDF5105R3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH 1 Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
Notes;