Report (2) 0regof d I S tty COde R403_ -
aFORM
Oh ' ;I;� yhc f nc�al onniractoti orthe owtict-builder
I pS ��oeti�---
at the following address:
Site Address. I tgl-1 S �(1/ I l0/__
City:
19nrot/ —
Penmit. ,J: /n�7,Cal- 00370
Subiivision/Lnt -ri q r Ve CCgCc+ R OS N{I\I� — — —
audio;
Map and Tax Lot. f,/. I I '77
l o conform with the 2014 Oregon Residential Specialty Code (ORSC), Section R408
Ventilation- I am notifying the b building official that I have installed the Moisture Barrier as per
Requitement in ORSC. Section 408.1 and have taken the following steps to itiect this code
rc-quircnicnt:
Lis] The ground surface of the under-i loci- space is covered with 6-mil black polyethylene
sheeting with
` -I loit1ts lapped 1 at sca.ni glut
Extending up the foundation walls 12"
Date: Z-3/ —2 3
G . ,eral Contractor or Owner 1t:iil ter
1'.111uildh� orarRI.S-wow, ,'ull}/?OI
(o! ( I 7 7
Form 640S 2017
Completion Certification—Site Inspection Li Trust
New Homes Program—Single Family f._'! ',Trust
of Oregon
To be completed by Verifier
CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment Info aatlen
Incentive Payee Company Name: (Polygon Northwest-WA Its this payment redirected?. 'No
Builder or Company: Polygon Northwest-WA Redirect to Name:
Verifier Payee Company Name: Performance Insulation end Energy Redirect Payee Corn
Affordable Housing No
Solar Ready Builder Incentive: No SSolar ReadyVerifier Inca No
Sae Information
Development RT 4 EASTRIDGE II MED ILot 11,77 Axis ID: I IREM/Rate®ID
Address. 14452 SW 165TH AVE.
Street Line 2 Multi-=amity INo City: TIGARD State: OREGON Zip: 97224
Total conditioned area Isq.ft.): 2,112 House Volume 1 22.844 Housing Type: Townhouse end
Number of Stories: 13 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 6 Na os
Slab Perimeter Insulation R. Slab Under Insulation R-
Framed Floor R. 30 Secondary Framed Floor R- 59.0
Insulation
Above Grade Wall Insulation R- 23 Below Grade Wall lnsulabcn R-
Flat Ceiling Insulation R. 49 Vaulted Ce.ling Insulation R-
Wlndows Windows U- SHGC.I Total window area I
Cooling Air Conditioning SEER: 0 Model 4-
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF. Model#'. ML196UHf70XE38B-54
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 1.92 Model if: ENT-50 130
Water Heating Fuel Electric Locative I Garage or ope AHRI Certificate.5360608
Ducts and Duct Location !Partial %ducts inside: Duct Leakage(CFM)Q 50Pa: INS'
Testing
Infiltration Air Changes per Hour IACHI Q 50Pa: 3.7
Ventilation Ventilation Type HRV/ERV Model.
Balance Airflow measured or why untestable? IRoo'Termination
Ap
Refrigerator kWtvw Model:
ENERGY STAR Diswasher kwhfyr Model. G13F510PSRSSS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I SShowerhead 1.75 GPH I
Nods:
� 177
Oregon S nc :-i.-tRty Code -0 _r18 2
MOISTURE CONTENT ACKNOWL "D GEMS NI FORM
1 /1 i NciQ 4/ , am the general contractor or the owner-huddei.
- --
at the following acidic:is:
Site Address: i LI5-2 5iz'1 (�
City:
( ri&
Permit #. CS l�fl21 - 00 37D --- —
subdivision/Lot. I t,Afd- Rivdr l�osKAK
Terr e
and/or
Map and Tax Lot. it: 1 7
To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and
OAR 918-480-0i40, I am notifying the building official that I am aware of the moisture content
Requirement of ORSC Section 123 I 8.2 and have taken steps to meet this code requirement.
[Section R318-2 is provided for refcrenccq.
R318.2 Moisture Content- Prior to the installation of interior finishes, the building
official shall be notified in writing by die general contractor that all moisture-sensitive
wood framing rnernbets used in construction have a moisture content of not more than 19
percent by dry weight of diy framing members.
��---- Date: 3/ -A3
Cr xFral Contnactor or Owner 1.iulld�r -----
L'.BwHir, `Form`RFS-MnimreSerplvc W„od der IN;rbn.T
Oreljoli Residential Speciad r Code Ninr
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Juri5t.liction, pC�
rnsr2,02,1— 00 37 9
Site Address: r
51" 16,7' h j�GL
Subdivision/Lot #: 17
(19A�Ge River rerrricei (�OShAk
and/or
Map and Tax Lot #: 11
77
By my signature below, I certify that a minimum of filly (50) percent of the penii nently
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a mitdlrnun efficacy of 410 lumens per input watt.
(Oregon Residential Specialty Code NI107.2)1
Signature: 7 _ 31— 27
_ Dale: ---- — -
O‘, et/General Con n
tractorlAulii eed Agent —
Print Name: ROI1 I- -Qeh
' t-)i;SC Section N l 107.2. high-efficiency interior lighting systems. A rniniwuui of fifty (50) percent a the
permanently installed lighting fixtures shall he installed with compact or linear (lirort:scent, or a lighting source drat
has a uruumuur ellcacy of 40 lumens per input watt Screw-in compact iluotescent lamps comply with this
requirement.
The building official shall tie notified in writing at the final inspection that a minimum of-Idly percent of the
permanently installed lighting fixtures arc compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
LA-Sutt,ime ,nms\R 1.•;-Il ghPfPn.ieury Lighrit ilr¢ 07'01)M