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Report (5) • PTCS Performance Tested Comfort Systems PTCS Duct Sealing Certification Form All sections must be filled out by a PTCS-certified Technician at the time of installation, signed and dated. A copy of the completed form must be promptly submitted to the utility and homeowner in accordance with utility policy. Please enter online at www.ptcsnw.con: or fax to 877-848-4074. Questions?Call 800-941-3867 or email ResHVAC @bpa.gov. Site Information (Please print clearly) PTCS +�,/yO Tech Jason Sullivan Install' 1'f 1h Customer's p Tech# 1 H Name Date -I 7 Electric Utility I Customer Installation I 00 O Co S W T-34-Name Site Address` '0 T-34- DP Site Site Site Zip A Customer City' i G 4-D State' op Code' 1 72 7.._$ Phone# ( ) *If mailing address is different,record here(#,City,St,Zip): Home Type(provide information for just one type,either a Site Built or Manufactured Home): Site Built Home: Existing K New Construction Manufactured Home: ❑Y p N S. a Built Home Foundation Type: #of Sections for a Manufactured Home: ❑1 ❑2 ❑ 3 Crawl Space ❑ Full Basement ❑ Half Basement ['Slab Super Good Cents? ❑Y ❑ N Year Built: to 1 4 Heating System: ❑Elec. Furnace ❑ Heat Pump Vas Furnace Heated Area Energy Star?❑Y 4 N ❑Other: Gas Company(if applicable): (sq ft) Required 2 18 Z gir Are at least 50%of the ducts in unconditioned space?[ Y El N #of supply registers #of returns If more than 50%of the ducts are in conditioned space,the home does not qualify for PTCS Duct sealing. i 2- House Pressurization and Duct Blaster Tests Do either of these special conditions apply? (check if"yes") Testing Equipment Used: O Record Only—no duct sealing work done ❑Energy Conservatory 0 RetroTec El PTCS Certification ONLY—pretest leakage too low for BPA program ❑AeroSeal ❑Air Care El Other: House Pressurized(Blower Door)to: Duct Blaster Location: Pressure Tap Supply Register Location: 0 +50Pa ❑Other Pa Fl Return Grille ❑Other: Duct Leakage Test:TYPICAL DUCT BLASTER CFM READING with Duct Pressure at OPa and Blower Door @+50Pa. DB Fan Pressure:Found using equipment;it is the fan pressure, not the house pressure. (Ex. Ring 1,78 Pa,364 CFM). Definitions:(DB)=Duct Blaster (BD)=Blower Door (AH)=Air Handler (SW)=Single Wide (DW)=Double Wide (TW)=Triple Wide New Construction Existing Home,New Ducts Existing Home,Existing Ducts Manufactured Home Pre-test Ring ❑Open❑1 ❑2 ❑3 ❑Open❑1 ❑2 ❑3 Not Applicable Not Applicable (select one) ❑H ❑M ❑L ❑H ❑M ❑L CU DB Fan Pressure Not Applicable Not Applicable Pa Pa I—. v DB CFM Not Applicable Not Applicable CFM CFM L — 0. Pretest ❑>_100 CFM,SW ❑>_250 CFM(>1667 sq ft) Requirements Not Applicable Not Applicable ❑?150 CFM,DW (BPA Only) ❑>15%of home's sq ft ❑,225 CFM,TW Post-test Ring ❑Open❑1 0 2 0 3 ❑Open❑1 0203 ❑Open 0 0 0 ❑Open El 0 El (select one) D H M D L 0 0 0 OH OM ❑L OH ❑M ❑L h DB Fan Pressure I o Pa Pa Pa Pa CU vl DB CFM 4 8 CFM CFM CFM CFM O ❑<_50 CFM,SW a Certification Req. <6%of sq ft w/AH ❑ <_10%of home's sq ft ❑<_80 CFM,DW (check all that ❑ <_10%of home's sq ft 50% ❑< apply) ❑ _4%of sq ft no AH ❑ _ 50%Reduction 120 CFM,TW ❑?50%Reduction The duct sealing at this site meets program requirements including:plenum,main ducts,takeoffs and boots sealed;a good faith effort was made to remove existing duct tape and cover with mastic;metal duct connections are secured with screws. 0 Y ❑ N Last updated:30 November 2012 Page 1 of 2 1 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I. ktzy AeLiNstcY , am the general contractor or the owner-builder at the following address: Site Address: 10006 sci, 766 /24Q.E. City: Permit#: 20/9'_0©07,3 Subdivision/Lot#: /2. 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: 24.4X___ Date: Q /S—2C7/5 General Contractor or wner-Builder 1:\Building\Form\RES-MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 2o1u_0007z Jurisdiction: k..:r Site Address: .240151% a&c:7 ez) 75,460 i3R Subdivision/Lot#: 1 Z 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: Date: 4/5Z0/`>~ Owner/General Contractor ri t Print Name: ALEx 1_4guksky 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\Forms\RES-HighEfficiencyLighting.doc 07/01/08 STREET TREE TIGARD GER TIFICA TION I, �i�S,_,�-5• , owner/agent for V/es- Cy Aye. , (PLEASE PRINT) (PERMIT HOLDER) do hereby certift that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: Sri E ADDRESS: .1,cc-e73) r /`44 SUBDIVISION: ZeT 4 ,. /Z - YE-N LOT #: /2 SIGNATURE: DATh: (OWNER/AG'I:. RECEIVED & i/H'RIFIED BY DATE: 7//4,,/ (CITY OF GARD) Tree location /'ci/fied per approved site plan. 1:\Building\Forms\Streee frceCcrtificatc 05/30/2012