Report (3) Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
Poh [, el14, , am the gen_eral contractor or the owner-builder
at the following address:
Site Address: ' to 5-6
7 /�{f PA 1 W`t, £o oP
City:
rd of —
Permit#: fv► i W)2 r 0 0 3
Subdivision/Lot#: /�
fZivet ecr/1Ce_
and/or
Map and Tax Lot#:
To confol a 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:
VI The ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
VI Joints lapped 12"at seams and
{ Extending up the foundation walls 12".
Signature: Date: Vi
� ���-�`` -----------
Gener ontracto or-Owner-Builder
L\Building\Form\RES-Moisturefarrier.doc 09/13/2016
Oregon. Residential Specialty Code R318.2
MOISTURE CONTENT ACIC4OWLEDGEMENT FORM
I, Rob Koe .v , am the general contractor or the owner-builder
at the following address:
Site Address: 1/_ 5107 (gy pR W(N Lo®P
City: 19,9td OR
Permit#: n
0030/1
Subdivision/Lot#:
t vet 'reaRce,
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:
eneral Contractor or Owner-Builder Date: CV/
1:113nilding\Form\RES-MoistureSen sitiveWood.dor. 09/25/08
Ore ;on Residential Specialty Code N1107.2
HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.:
f 7- 71 g.09.f —00 3 Oti Jurisdiction:
-- _ i rd
Site Address: — ------
7 5 iv OR Loop
Subdivision/Lot#:
tve� -rgcr4CC
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 Iighting source that has a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)1
Signature:
Owne General Contractor/Authorized Agent Date: /
Print Name: 1 °h Kp h
' OR SC 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 l0 lumens per
input watt.
1:\Building\Poims\RES-11igliEfficiencyLight ing.doc 07/O1/OR
Form 640S 2017
Completion Certification—Site Inspection
New Homes Program--Single Family � „'""�� �„ eo ■
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 Corn
Affordable Housing No
Solar Ready Builder Incentive: No 'Solar ReadyVerifier Inc4No
site Information
Development: RT4 EASTRIDGE II MED Lot 1c, r, �TAxis ID: REM/Rate®ID'.
Address:
Street Line 2 Multi-Family No City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.n.). 3,150 House Volume. I 31,500 Housing Type. Detached single family
Number of Stories: ]3 Number of Bedrooms: 5 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
q pment 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 10.3 Total window area: I
Cooling Air Conditioning SEER: 0 Model#.
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH090XE48C-51
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
Location. Attic Outdoor Unit(for heat pumps)
ECM: No Model#. I
AHRI Certificate:4805339 #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 op.
Ducts and Duct Location Partial %ducts inside :<' 11 Duct CFM Leakage
( )@ 50Pa:
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa. 3.07
Ventilation Ventilation Type HRV/ERV Model
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWNyr 664 Model GZS22DSJPFSS
ENERGY STAR Diswasher kWh/yr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting)%) Thermostat
Showerhead 1.5 GPH' Showerwand 1.5 GPH I Showerhead 1,6 GPH I IShowerhead 1.75 GPH I