Report Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, y L04- ! t st31. , am the general contractor or the owner-builder
at the following address:
Site Address: . 6 5 40Ffro "Diu I ii (mot
City: L1612/0
Permit#: ,, ?.OZ I , 0 n3 a I
Subdivision/Lot#: ? 1,6 T 2-6
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.
j
Signature: 0.11C0fr------ Date: 3P Z
General Contractor or - u er
I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: M�, - z- z i , 0050 I Jurisdiction: -" &- -aJ3
Site Address: { Lo 5.4 DcsvO `>j ( !Il( L-D p P
Subdivision/Lot#: 'vex L DT o I
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
P-b4e —
Signature: .._ Date:
Le7sti z Z
Owner/General C ctor/Autho ed Agent
Print Name: C/;4 7r L/1_7--giVi --7‹.6
1 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:\Building\Fornu\RES-HiighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, IAA(L,02_ tit trY244cTht , am the general contractor or the owner-builder
at the following address:
Site Address: lie 5 4 D r *J Lov
City:
Permit#: Zp 2( — O p -0 1
Subdivision/Lot#: s(tl t_D-T- 2 0 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:
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 / o 2_
Signature: Date:
General Contractor o
I:\Building\Form\RES-MoistureBarrier.doc 09/13/2016
Form 640S 2017
Completion Certification—Site Inspections
New Homes Program—Single Family ,.,.. a r yTt us t4».
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 Com
Affordable Housing No
Solar Ready Builder Incentive: No (Solar ReadyVerifier Inc No
Site Information
Development 4 LAST RIDGE _IL ut '201 Axis ID I (REM/Rate®ID:
Address: 16540 SW DARWIN LP
Street Line 2 Multi-Family INo City: TIGARD State: OR Zip: 97224
Total conditioned area(sq.ft.): 2,703 House Volume: I 25,635 Housing Type: Detached single family
Number of Stones. 12 Number of Bedrooms: 4 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- 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-
Flal Ceiling Insulation R- 49.0 Vaulted Ceiling Insulation R-
Windows Windows U- 0.3 SHGC:I0.3 Total window area: I
1
Cooling Air Conditioning SEER: 0 Model#:
Primary Healing System Details AFUE: Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH090XE4BC-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: fb'A Duct Leakage(CFM)@ 50Pa [I r,, il,; e
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.38 (
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 kWNyr Model: GE
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I I Showerhead 1.6 GPH ( IShowerhead 1.75 GPH I
Notes: