Report (3) Oregon Residential Specialty Code R.408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
, am the general contractor or the owner-builder
at the following address:
Site Address:
1 y 31111 6p0
City:
Permit ifs: _ )21� _ /I
Subdivision/Lot#: '
j�`�_ 1,22 4, 1 173 AD"
and/or
Map and Tax Lot#:
To confornt 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:
[V The ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
[172Joints lapped 12" at seams and
pi Extending up the foundation walls 12".
Signature: " Date: 8-2 2
Geueral Con ra t 7 udder
I:U3uildingWorn\RE>-Moisntrel3arrier.doc 09/13/2016
Oregon. Residential Specialty Code N1.107,2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: In A 194)ZI _ W Jurisdiction: Trislip)
Site Address: '( 3q
Subdivision/Lot#: :LeSVL__4k-e- (l7 3 / v 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)t
r
Signature: Date: 2-
0 rrr r i for/Authorized 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 440 lumens per
input watt.
t:ABuilding\Forms\RF.S-ttigli[fiiciencyi.igloing.',toc 07/01/05
Oregon Residential. Specialty Code 11318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
1, _ o7// --- , am the general contractor or the owner-builder
at the following address: —P/\
•
Site Address:
City:
Permit#: 444 c� 00
Subdivision/Lot#:
__1(70124/1-07V4&- 1177
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 t:he 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: G T' & -' R2>
Gener ontrac r O fBuilcier
L\Building\-onn\RES-MoistureSensitiveWnod.doc 09/25708
.. ..
Form 640S 2017
Completion Certification—Site Inspection d r* s' ""
New Homes Program—Single Family `3^ ■ +r
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 IncelNo
Site Information
Development RI 4IASTRIDGF II MFD toi------=1173 Axis ID. J 'REM/Rate®ID
Address: 14344 SW t65TH AVE
Street Line 2 Multi-Family 'No City. TIGARD State: OREGON Zip 97224
Total conditioned area(sq.ft.). 1,726 House Volume. I 15,471 Housing Type: Townhouse inside
Number of Stories: 12 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
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- 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:
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#: RE250T6-1NCWW
Water Heating Fuel Electric Location: 'Garage or ope AHRI Certificate 9952297
Ducts and Duct Location 'Partial %ducts inside: [WA ADuct Leakage(CFM)@ 50Pa. 1189
Testing "----"
Infiltration Air Changes per Hour(ACH)@ 50Pa: 4.93 I
Ventilation Ventilation Type HRV/ERV Model.
Supply Side-Air Cycler 'Airflow measured or why untestable? j Roof Termination
Appliances
Refrigerator kWNy Model
ENERGY STAR Diswasher kWh/yr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH [ 'Showerhead 1.75 GPH I
Notes: