Report 9earia• �� Ms7 ,/ç, 776
Form 640S 2017
Completion Certification—Site Inspection Trust
New Homes Program—Single Family
of Oregon
To be completed by Verifier
CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment information `�.T
Incentive Payee Company Name. (Pacific Lifestyle Homes-_ 110 this payment redirected? INo
Builder or Company: _Pacific Lifestyle Homes Redirect to Name: --,
Verifier Payee Company Name: Performance Insulation and Energy _ Redirect Payee Com
Affordable Housing No
Solar Ready Builder Incentive: No (Solar Ready Verifier IncelNo
Site Information
Development Willow Brook Lot40 , 7Axis ID: 1 LREM/Rate0 ID
V», -
Street Line 2 Multi-Family [No City: TIGARD State: OR Zip: 97224
Total conditioned area(sq.ft.): 1,814 House Volume: 16,507 Housing Type: Detached single family
Number of Stories: I'1 Number of Bedrooms: 3 Foundation Type: Crawlspace
Electric Provider: Portland General Electric Gas Provider: NW Natural Gas
Solar installed Solar Installer Name/Company
Blue shaded fields are required for EPS sheet
Verification `Type Actual Model Equipment Details B Notes
Slab Perimeter Insulation R- 0.0 Slab Under Insulation R-
Insulation
Framed Floor R- 30.0 Secondary Framed Floor R.
Above Grade Wall Insulation R- 21,0 Below Grade Wall Insulation R-
Flat Ceiling Insulation R- 49.0 Vaulted Ceiling Insulation R-
Windows Windows U- 0.3 SHGC:10.3 Total window area: 1225
Cooling Air Conditioning SEER: 0 Model#:
Primary Heating System Details AFUE: 0 Brand Trane
Type: Electric Heat Pump-Air Source Ducted HSPF: 9 Model#: S9X2B040U2PSABA
Heating Fuel: Electric SEER: 14
Primary Heat
Source Comment: COP:
Location: Garage or ope Outdoor Unit(for heat pumps)
ECM: No Model#. IRP1436AD1
AHRI Certificate:7889783 #of Systems 11
Gallons: 150 Brand: Rheem
Water Heater Type Storage EF: 1.60 Model#: PR0G50-38NRH 60
Water Heating Fuel Gas Location: !Garage orope AHRI Certificate:
Ducts and Duct Location 'Unconditioned %ducts inside: '',r Duct Leakage(CFM)@ 50Pa: 152
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.99
Ventilation Type HRV/ERV Model.
Ventilation
0 Airflow measured or why untestable? I Roof Termination
Appliances
Refrigerator kWh/yr Model:
ENERGY STAR Diswasher kWh/yr 270 Model: FGID2476"'B
Percent High Efficacy Interior Lighting)%) 100% Thermostat
Showerhead 1.5 GPH 1 Showerwand 1.5 GPH I Showerhead 1.6 GPH 1 1Showerhead 1.75 GPH I
Notes:
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, J t'p i RAV-61:( , am the general contractor or the owner-builder
at the following address:
Site Address: 1 H' ( 5 L.A) 6:A g1Z, 6(-. SL
City: --T- A, '% O12 �7,,"i.
Permit#: /151-101 t) :_ 00 1 1 S
Subdivision/Lot#: W '�O/= , ,
and/or
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 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:
jg The ground surface of the under-floor space is covered by a Class I vapor retarder or
other approved materials, with
R. Joints lapped 12 inches at seams and
0 Extending up the foundation walls 12 inches.
Signature: Date: dila 11
Gen or or Owne udder
I:\Building\Form\RES-Moi stureBarrierAcknowledgement_02201 8
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 01:21 , am the general contractor or the owner-builder
at the following address:
Site Address: I / SL,t) 6A � (f✓ 577
City: A / ag. 10-1
Permit#: l -5G soli 0o1 7l/
Subdivision/Lot#: J
and/or
Map and Tax Lot#:
To conform with the 2017 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.
ti
Signature: Date: A.
r.,
Gene .1 •ntractor or Own uilder
I:\Building\Form\RES-Mo i stureContentAcknowl edgement_022018
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: c ^u7 I i-- OO G 7 f3 Jurisdiction: ( J ( cc "Cr(
Site Address: l (Li IL/
5 6A ( -ft F 1I6AreD i 01- 17 s.Y
Subdivision/Lot#: �v 'g - -7
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: ��) (116/1C;
Owne e ral Contractor/A prized Agent
Print Name: J oQ Y 15.`.At61' l'
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:\Building\Forms\RES-HighEfficiencyL ightingAcknowledgement_022018