Report (2) )ccg°o.n tcsidcfiii. d airy y Code K408 .
MOIST U RL I AR f R AC94n..NO W 1.,ED FEMLJN [ FORM
Rob 1/�ti� an? die general contractor or the owner-builder
, ----- ----- ---
at the following address:
Site Address.
City: 1�
Ark
Permit. ;,': 1Y — oo3(oy
Suldivision/Lot ,'i: Ft r River l CrgCc RoS�PK — —
andiot
Map and Tax Lot '1,`- 177 —
To conform with the 2014 Oregon Residential Specially Code (ORSC), Section R408.1
Ventilation_ I am notifying the building official Iiiat I have installed the Moisture Barrier as per
Requirement in ORSC Section 403.1 and have taken the following steps to meet this code
re-iluii-e ucnt:
C � The ground surface of the under-fluor space is covered with 6-mil black polyethylene
sheeting with
ri(c. loin. tapped 1--" at seams an:l
(Extending up the foundation walls 12 .
3
Signature: ..
G eral Contractor or Owner i .:,ider
!.ARultdiilo:orriNu,s Mniciurcl 1);!:tin'A
Goo lam/
•
Form 6405 2017
Completion Certification—Site Inspection E.n e rgyTru st
New Homes Program-Single Family
of Oregon
To be completed by Verifier
CLEA Result is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment Information
Incentive Payee Company Name: 'Polygon Northwest-WA Its this payment redirec:edc INo
Builder or Company. Polygon Northwest-WA Redirect to Name:
Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Com
Affordable Housing No
Soler Ready Builder Incentive' No 'Solar ReadyVerifer IncrINn
Site information
Development: RT 4 EASTRIDGE II MED 1177 Axis ID. I 'REM/Rated ID.
Address: ifL1513 W:165TH AVE:
Street Line 2 Multi-Family 'No City: TIGARD State: OREGON Zip: 97224
Total conditioned area(sq.ft.)'. 2,514 House Volume I 28,948 Housing Type: Townhouse end
Number of Stories'. 13 Number of Bedrooms: 5 Foundation Type: Crawispace
Electric Provider: Portland General Electric Gas Provider NW Natural Gas
Solar installed None Soler 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-
InsulationFramed Floor R- 30 Secondary Framed Floor R- 59.0
Above Grade Wall Insulation R- 23 Below Grade Wall Insulation R-
Flat Ceiling Insulation R- 49 Vaulted Ceiling Insulation R-
Windows Windows U- SHGC.I Total window area', I
Cooling Air Conditioning SEER: 0 Model t. 13ACXN036-230-23
Primary Heating System Details AFUE: 95 Brand Lennox
Type: Gas Furnace HSPF: Model a:: ML196UH070XE36B-54
Heating Fuel: Gas SEER
Primary Heat -
source Comment COP:
Location: Attic Outdoor Unit(far heat pumps(
ECM: No Model a:
AHRI Certificate:4805339 a of Systems 11
Gallons: I Brand: AOSmith
Water Heater Type Heat Pump EF: 1.92 Model it: ENT50130
Water Heating Fuel Electric Location: 'Garage or ono AHRI Certificate:5360608
Ducts and Duct Location 'Partial %ducts inside: Duct Leakage(CFM)®50Pa: 1144
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 3.6
Ventilation Ventilation Type HRV/ERV Model.Supply Side-Air Cycler Arttow measured or why unlestable? I Roof Termination
Appliances
Refrigerator kWblyr Model;
ENERGY STAR Diswasher swhiyr Model: GOF510PSR5SS
Percent High Efficacy Interior Lighting(%) Thermostat
Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH ' IShowerhead 1.75 GPI- I
Notes:
td 0177
reron Rr "s9 de;: "ai 1( ;_s' a d ;tt3: r Code .®_'A,3_1_8.2
MOIST CONT'ENT ACKNOWLEDGE ' _ENT FORM
Mah -- — , am the general contractor or the owner-builder
at iho following address:
Site Address: l KW so w 10— 111_ _.v4-- -- - - -
City:
Permit tl: i�021- o0 30 ---
Subdivision/Lot OS
V9R/44 (ever Terrfxe �_ HAK
anul/or
Map and Tax Lot If: 77
_ —--
To conform with.the 200f Oregon Residential Specialty Code (ORSC), Section R318-2 and
OAR 9I8-480-0140, 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 requireimlent-
[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 v.Nrit:ing by the general contractor drat all moisture-sensitive
wood framing rneuvbers used in construction have a moisture content of not more than 19
percent by dry weight of dry training members.
31 —23
Date:
Signature: 7 -
G at cArn- actor or c1a'nct-liuiI(Irt
I-,[ llk(ii10+Lt'orm`RG,5 I !sr rc,SeTNilivCW ook itnr I)?,2511lft
Oregon_ Residential Stijl aria ly Cede N1107 ')
R :NCY INTERIOR LIGHTING SYSTEMS
Permit No.: .lurisdiction: rq���
msreX al- ao3��Site Address: (9`1 5-Q fLo
five-
subdivision/Lot #: 119R 1c Nik(' 1 Qcfgce
f_ RoShAK
and/or
Map and Tax Lot #: 1?7 — — — —By my signature below, I certify that a minimum of fifty (50) percent of the penrtanentiy
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a miwutunl efficacy of 4lf ltunens per input watt.
(OregonResidential Specialty Code NI l07.2)1
Date: 7 -
3r 23
o, el/General ContractodAuthorized Agent
Print Name: golf L'Coen ------------
OI:SC; Section N 1107.2. High-efficiency interior lighting systems. A nainimunt of (illy (50) percent a the
permanently installed lighting fixtures shall be installed with compact or linear tluotcsceut, or a lighting source that
has a minimum efficacy of 410 lumens per input wail. Screw-in compact fluorescent Luray;comply with this
requirernent.
The I,uildmg official shall be notified in writing at Ilse final inspection that a minimum of filly percent of the
permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
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