Report (3) Oregon Residential_ Sped lty Code N1.107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: at 9 Jurisdiction.
Site Address: ' L1272,
_Aka
Subdivision/Lot#: et.Z' AnA f
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)'
Signature: �tea
Date:_
---._-. __ .
O ;tor/A.uthorized Agent—
Print Name:
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\RPS-NigliPffrienryl.igLiing.d0c 0h o t/08
Oregon Residential. Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT :FORM
I. "4/— , am the general contractor or the owner-builder
at the following address:
Site Address: f 6t) AAe,
City:
et cc/WO)
Permit#: /2_)-i)21— 006
subdivisiona.ot#:
c'k \-12-7 (4007.
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:
[fri The ground surface of time under-floor space is covered with 6-mil black polyethylene
sheeting with
[-CI Joints lapped 12" at seams and
rt-A Extending up the foundation walls 12".
• /
Signature: Date: 6
General 6)u ra t w .2-Nader
\fluildingTornaRS-Moistnrellanies.do 09/13/2016
Form 640S 2017
Completion Certification—Site Inspection Ene *�
New Homes Program—Single Family � �A.AI�t<w.
4.„:
Of 0 rego€Y
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!nett No
Site Information
Development RT 4 EAS I RUC II Mt I) _ II oi 12174 Axis ID: I !REM/Rate*ID:
Address: 1+42725W 165TH AVE
Street Line 2 Multi-Family INo City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.): 1,848 House Volume: I 16,753 Housing Type: Townhouse end
Number of Stories: 12 Number of Bedrooms: 3 Foundation Type: Crawlspace
Electric Provider: Portland General Electric Gas Provider: INW Natural Gas
Solar installed None Solar Installer Name/Company: 1I
Blue shaded fields are required for EPS sheet
Verification Type Actual Model Equipment Details 8 Notes
Slab Perimeter Insulation R- 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:I0.3 Total window area:
Cooling Air Conditioning SEER: 0 Model#:
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH045XE36B-51
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
Location: Attic Outdoor Unit(for heat pumps)
ECM: No Model#:
AHRI Certificate:4805339 #of Systems 11
Gallons: 165 Brand: BradfordWhite
Water Heater Type Storage EF: 13.4 Model#: RE2501-6-1NCWW
Water Heating Fuel Electric Location: 'Garage or ope AHRI Certificate:9952297
Ducts and Duct Location 'Partial %ducts inside: 4.5 Duct Leakage(CFM)@ 50Pa: 1178
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 3.69 I
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? (Roof Termination
Appliances
Refrigerator kvv Nyr Model:
ENERGY STAR Diswasher kWh/yr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH 1 Showerwand 1-5 GPH 1 Showerhead 1.6 GPH 1 IShowerhead 1.75 GPH I
Notes: