Report Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: MVZ0Z2—dd2 GJurisdiction:
Site Address: ,*' '*.s. G24�- Si43 Luistv-V-t a7r
Subdivision/Lot#: � (4 . LS
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 N1107.2)1
Signature: Date: erj1/2
Owner/General Contractor/ t ed Agent
Print Name: 71,707,471(
1
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.
I:1Buildi ngWocroslRES-HighEfficiencyLightingAcknowledgement_022018
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, v,cal&A- IL y?off , am the general contractor or the owner-builder
at the following address:
Site Address: qz,/ 2 SW wad-I/GL,0 ��
City: —7;.� (J
Permit#: /'
Subdivision/Lot#: �¢0/..e, 16 — 1 a,�, (03,
and/or C_
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 1 have installed the Moisture Barrier as per
Requirement in ORSC Section 408.1 and have taken the following steps to meet this code
requirement:
The ground surface of the under-floor space is covered by a Class 1 vapor retarder or
other approved materials, with
/17 Joints lapped 12 inches at seams and
--Nrti
Extending up the foundation walls 12 inches.
Signature: Date: /7/L..3
neral Contractor or Owner ' er
I:\Building\Form1RES-MoistureBarrierAcknowl edgement_022018
Oregon Residential Specialty Code M1505.4
Balanced Mechanical Whole-House Ventilation System Installed
Permit No.: M ST2_022 --dc,,2�o Jurisdiction:—q�
/V
Site Address: q ziz �� Wa"ki- llyl -A:Dv--
Subdivision/Lot#: Ego Le_ v.ti - V 1-at
and/or
Map and Tax Lot#:
By my signature below, I certify that the Mechanical Whole-House Ventilation System has been
installed at the address listed above per the requirements of the Oregon Residential Specialty
Code and Section M1505.4.
Signature: Date: 5 V2-3
Owner/General Contractor/ tho ized.Agent
Print Name: •N .v-vaTS
I:\BuildingWorms\RES-HighEfficiencyLightingAcknowledgement_022018
Oregon
Backflow
BACKFLOW ❑EXISTING .___. REMOVED
PREVENTER REPORT EE'}}--==��{NEW REPLACED
REPAIRED OLD S/N:
PROPERTY NAME Oregon Sustainable Landscape LLC PHONE 503-807-8375
CONTACT NAME Tim Fidanzo PHONE
MAILING ADDRESS 4237 SE Jefferson
ciTY Milwaukie STATE OR zip 97222
PREVENTER ADDRESS 9212 SW Waverly Dr. Tigard, OR 97224
WATER SUPPLIER Tigard SERIAL# AJQ2485
LOCATION Front
MAKE Wilkins MODEL 350 SIZE 1"
TYPE n RP RPDA RPDA-II IX DC n DCDA ® DCDA--F1 I I PVE SVB I I AVB n AG
HAZARD PROTECTED LI PREMISES ISOLATION ® IRRIGATION n FIRE SYSTEM I] BOILER I I OTHER
APPROVED: ® ASSEMBLY El INSTALLATION ICI ORtF.NTATION [] AIRGAP PIPE SIZE in SP9r"vscn,. in
pkATION
REDUCED PRESSURE ASSEMBLY — PVRA/SVBA INITIAL TEST
DOUBLE CHECK AIR INLET CHECK VALVE PASSED X
CHECK#1 CHECK#1 TYPE n n OPENS)AT: PRESS DROP:
PRESS
aeon TIGHT X FAILED
INITIAL MRN S PSID 2.5
TEST RELIEF VALVE LEAKED n MIN I PM MIN I PSID MIN I P$ID DATE 08-1 1-23
RESULTS OPI:%RD AT: OPENED _
MIN 2 MIDCHECK#2 FULLY L_I FAILED SYSTEM PSI 67
RELIEF VALVE: TIGHT [Xl DID NOT n DETECTOR METER
EASE„ n EARN) I 2.2 ! OPEN I READING:
LEAKED I I Mix,PsiD 1
NOTES
REPAIRS
PARTS
REDUCED PRESSURE ASSEMBLY TEST
CHECK#1 DOUBLE CHECK PVBA/SVBA AFTER REPAIRS
PRESS CHECK#I
DROP: TYPE II AIR INLET CHECK VALVE
REPAIR MIN5 PSID TIGHT I 1 OPENED AT: PRESS DROP:
RESULTS RELIEF VALVE DATE
OPRNPD AT: CHECK#2 MINI PEW- MIN t MAD 7 MIN I PRID
RIME VALVE MIN2PSID TIGHT I rI PASSED
man ❑ FAILED n MINI MID
GAUGES/N 02AC21090173 MAKE/MODEL Mako M K5 CALIBRATION DATE 08-29-2022
In completing and submitting this test report,the tester certifies that the assembly was tested and maintained in accordance with all applicable
rules,laws,codes and regulations of the slate and watcr system using approved testing equipment and approved testing procedures.
INITIAL TEST TEST AFTER REPAIRS
� , 675E
TESTER SIGNATT I• TESTER SIGNATURE TESTER LIST#
Ryan Yancey 503-491-9402
'IESTE,R NAME(PRINTED) ' TESTER NAME(PRINTED) PHONE#
PO Box 230113 Tigard, OR 97281 deanna@obtllc.com
TESTER ADDRESS ' TESTER ADDRESS EMAIL
Oregon Backflow Testing, LLC
COMPANY NAME COMPANY NAME un
WATER RESTORED?
!FOUND OFF,LEFT OFF
REPORT RECEIVED BY(REPRESENTATIVE OP OWNER) REPORT RECEIVED IW(REPRESENTATIVE OP OWNER)
- srt 7a2Z - 00'26 '7
INSULATION CERTIFICATE
Building Number: 1 �L y
Number and Street: 71) L Sw (4.42,...f1,a Dr City: 17 jsk-4 Zip: 9 y-72-Y
Contractor:
4,-ReoF
Insulation Type: Brand Name: d we.Vl,-S
Thickness added(inches): '(a," Thermal resistance added(R-Value):
Total Thermal Resistance(R-Value): 1/ Insulated area: /24".4 ft2
2.CEILING Dense pack:❑ Loose fill:❑
Insulation Type: Brand Name:
Thickness added(inches): Thermal resistance added(R-Value):
Total Thermal Resistance(R-Value): Insulated area: ft2
3.EXTERIOR WALL
Cavity frame type: 2"x4"❑2"x6'' Dense pack:❑ Loose fill:❑
Other: T�
Insulation Type: K, Brand Name: ef-A/,t'. S
Thermal resistance added(R-Value): 7) Total Thermal Resistance(R-Value): 2.1
Insulated area: 30o0 S`i' ft2
4.FLOOR y�
Insulation Type:' 1:30i, L G' Brand Name: (� 5
Thickness added(inches): 0 Thermal resistance added(R-Value):
Total Thermal Resistance(R-Value);: Insulated area: Sc' 5 f ft2
5.RIM JOIST(Perimeter)
Insulation Type: Brand Name: Q,ti
Thickness added(inches): Thermal resistance added(R-Value): Z)
Total Thermal Resistance(R-Value): `Z.t Insulated area: LifC;°' ft2
6.FOUNDATION WALL
Insulation Type: . + 3 ro,,r„h Brand Name: 6✓t.+-c-TS
Thickness added(inches): 3 Thermal resistance added(R-Value): /5
Total Thermal Resistance(R-Value): 9al i S Insulated area: [ ft2
•4 CERTIFY THAT THE RESIDENCE IDENTIFIED ABOVE WAS INSULATED
AS SPECIFIED ON THIS CERTIFICATE AND THE INSTALLATION WAS CONDUCTED IN CONFORMANCE TO
APPLICABLE CODES,WEATHERIZATION STANDARDS AND PROGRAM REGULATIONS.
1-6 11/c p70 13.1A Crr
Item#s Si ature Date Installing Subcontractor or Wx Subgra t ee
Item#s Signature Date Installing Subcontractor or Wx Subgrantee
Item#s Signature Date Installing Subcontractor or Wx Subgrantee