Report (3) Oregon Residential Specialty Code R4O8.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
1, ( ob K9eke/ _ , am the general contractor or the owner-builder
at the following address:
Site Address: 66 La,
S w r0 w,v S V al g sr
City: f t&Ark
Pennit#: (l ST9o2.I 00 Lf9G
Subdivision/Lot (n vcr 1"e cr Mce tor 1 I(o pay j..
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:
QThe ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
EJoints lapped 12"at seams and
J Extending up the foundation walls 12".
Signature: Date: Co—AO 21,
Gen Contractor or Owner-Builder
1sU3uilding\Form\RES-MnistureHarricr.doc 09/13/2016
i
4
ti
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
1, Rob Voeh✓ , am the general contractor or the owner-builder
at the following address:
Site Address: 1(4 410 5w To W N SV•de 5r
City:
Ti&Rtd a k
Permit#:i M5r 9091 00414
Subdivision/Lot#: River I errA re Lor mite AN/ 1
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: (0/A0 "X?,
neral Contractor or Owner-Butlder
1:\Building\Form\RF.,S-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: ('fir -QQ 4v, Jurisdiction: GAr‘i
Site Address: 1(f to 'go 5w Tr wpsi:ug �r
Subdivision/Lot#: 11, Terrace e Lor (11(0 (9pv
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: /r Co— ®",12,
Owne eneral Contractor/Authorized Agent
Print Name: P oh K4eh,v
' 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-HighEfciencyLighting.cloc 07/01/08
[ 2 /,„
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•
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•:.
,. Form 640S 2017
Completion Certification—Site Inspection
• 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 'is this payment redirected?. INo
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 Braider Incentive: No 'Solar ReadyVerifier Ince1No
I.
Site Information
11
Development 4 EASTRIDGE __Li T 11216 Axis ID: I IREM/Rate®ID:
Address 16646 SW TOWNSVILLE ST. T
Street Line 2 Multi-Family INo City: TIGARD State: OR Zip: 97224
Total conditioned area(sq.ft.): 1,293 House Volume: I 11,766 Housing Type: _Detached single family
Number of Stories: 11 Number of Bedrooms: 3 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
t
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-
I Windows Windows U- 0.3 SHGC:I0.3 Total window area: I
Cooling Air Conditioning SEER: 0 Model it:
Primary Heating System Details AFUE: Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH070XE36B-52
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
I Location: Attic Outdoor Unit(for heat pumps)
ECM: Model#. I
#of Systems 11
Gallons: 165 Brand: BradfordWhite
Water Heater Type Storage EF: '3.4 Model#: RE250T6-1NCWW
Water Heating Fuel Electric Location: (Garage or ope AHRI Certificate:9952297
Ducts and Duct Location 'Partial %ducts inside: Duct Leakage(CFM)@ 50Pa: Ir231
• Testing ..._.. __-_.. _...,
• Infiltration Air Changes per Hour(ACH)@ 50Pa: 4.59 I
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWh/yr 664 Model. GZS22DSJWFSS
ENERGY STAR Diswasher kWhdyr _Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
• Showerhead 1.5 GPH I I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
Notes: