Report (2) Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
h Rob KQ&h j , am the general contractor or the owner-builder
at the following address:
Site Address: 766/ 09 f7( 4 f A-
City: c! 97 Ed-
Permit#: (h5T- 02! _00 3(8
Subdivision/Lot#: Rosift< IS n I v�
/)9e p I �P <e
and/or
Map and Tax Lot#:
To conform with the 2017 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:
+-r- The ground surface of the under-floor space is covered by a Class 1 vapor retarder or
other approved materials, with
Joints lapped 12 inches at seams and
J] Extending up the foundation walls 12 inches.
Signature: L/ ` Date: /°—�(D���
Ge eral Contractor or Owner-Builder
C\Building\Form\RES-MoistureBarrierAcknowl edgement_022018
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, p0t joa4 , am the general contractor or the owner-builder
at the following address:
Site Address: I6G Oq DR(w LODn
City: fj911 rcC.
Permit#:
[►lfri,021 — 00348
Subdivision/Lot#: RO Sf f A(< p9 •
.1Qd( ((areAce
and/or
Map and Tax Lot#:
To conform with the 2017 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: l / Date: /0 -20_2
er Contractor or Owner-Builder
I:1B ui lding\Form\RES-MoistureCo n tentA cknowl ed gement_022018
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: rn5T.021-00 36g Jurisdiction: --6.9
Rrd
Site Address: l i(G o9
nf}rw�N [ooP
Subdivision/Lot#:
('0 S If AK Rv Pc e I ver T ra ce
and/or
Map and Tax Lot#:
By my signature below, I certify that all of the permanently installed lighting fixtures in the
above mentioned building contain high-efficacy lamps. Screw-in compact fluorescent and LED
lamps comply with this requirement. (Oregon Residential Specialty Code Ni 107.2)1
Signature: /G '`tom Date: /4 —Z0 ZZ
O er/General Contractor/Authorized Agent
Print Name: R0h er0Ch
ORSC Section N1107.2.High-efficacy lamps. All permanently installed lighting fixtures shall contain high-
efficacy lamps. Screw-in compact fluorescent and LED lamps comply with this requirement.
The building official shall be notified in writing at the final inspection that the permanently installed lighting fixtures
have met this requirement.
Exception: Two permanently installed lighting fixtures are not required to have high-efficacy lamps.
1:\Building\Forms\RES-HighErticiencyLightingAcknowledgement_02201 8
Form 640S 2017 Co '�`
New pletionHomes Cert Stion—Site Inspection Energy Trust
rust
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?: No
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 Ince No
Site Information
Development: RT 4 EASTRIDGE II MED Lot Axis ID: REM/Rate®ID:
Address:
Street Line 2 Multi-Family No City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.): 3,993 House Volume: 43,267 Housing Type. Detached single family
Number of Stories: 13 Number of Bedrooms: 5 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 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-
Windows Windows U- 0.3 SHGC: 0.3 Total window area:
Cooling Air Conditioning SEER: 0 Model#:
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model 4: ML196UH090XE48C-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 1
Gallons: 66 Brand: AOSmith
Water Heater Type Heat Pump EF: 3.17 Model#: HPTU-66N 130
Water Heating Fuel Electric Location: Garage or ope AHRI Certificate:
Ducts and Duct Location Partial %o ducts inside' - Duct Leakage(CFM)@ 50Pa:
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa. 2.1
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? (Roof Termination
Appliances
Refrigerator kW Nyr 664 Model: GZS22DSJPFSS
ENERGY STAR Diswasher kWh/yr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH Showerwand 1.5 GPH Showerhead 1.6 GPH Showerhead 1.75 GPH
Notes: