Report (2) Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, T A-' L.0)Z M 0' Q4 , am the general contractor or the owner-builder
at the following address:
Site Address: I t,` �? � L 5
City: i o
Peuuit#: M Yr' j9 _
Subdivision/Lot#: R ocwifer, p -
b..� / 6ci
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:
l"I r ne ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
Joints lapped 12" at seams and
[^ending up the foundation walls 12".
Signature: l.�/ Date:
eneral Contrac or caner- uz
1:\Building\Form\RES-MoistureBamer.doc 09/13/2016
•
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, I Y Lb(t M 1 5 , am the general contractor or the owner-builder
at the following address:
Site Address: ` •9 1 �y
City: 1-1 Cal' 0
Permit#: - 2Offi _ 451)
Subdivision/Lot#: `Ro I i9- _ L CIF / (, j
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: Sre/ft (`/ Date: -5.12 4//2:2—
General Contractor o caner-Builder.!
I:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: ri 0 q C)4.5 Jurisdiction: ( ({.R_,6
Site Address: I .234 1 n„i
Subdivision/Lot#: R c ail`}&- LDT 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
Signature: 4/ /2-1/2Date:
Owner/General ontractor/Auth9sized"Agent
Print Name: 57ô1T L'/rr. da
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.
1:\Building\Forams\RES-HighEfficiencyLighting.doc 07/01/08
Form 640S 2017
CompletNew Homes Program—Single n Certification—Site Inspection 11 \ lr•\, c'INf
of r a t o fY
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 IncelNo
Site Information
Development RT 4 EASTRIDGE II MED Lot L r a)ktrA\r rr,Axis ID: REM/Rate®ID:
Address kt` r Arvrr. rur;`aabtAgaQ\ ��Vr'r Sr9000t-.
Street Line 2 Multi-Family No City: TIGARD State: OREGOF Zip: 97224
Total conditioned area(sq.ft.): 2,929 House Volume: I 29,581 Housing Type: Detached single family
Number of Stories: 11 Number of Bedrooms: 4 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 8 Notes
Slab Perimeter Insulation R- Slab Under Insulation R-
InsulationFramed 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#: 13ACXN036-230-23
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model#: ML196UH070XE36B-52
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
Location: Conditioned A Outdoor Unit(for heat pumps)
ECM: No Model 0
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 ope
Ducts and Duct Location 'Partial %ducts inside: A: Duct Leakage(CFM)@ 50Pa: rOR r M
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 3.02
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 kWivyr Model: GDF510PSR3SS
Percent High Efficacy Interior Lighting(%( Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I
Notes: