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Report Form 640S 2017 Completion Certification—Site Inspection New Homes Program—Single Family ` - st of Oregon To be completed by Verifier CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc. Payment Information Incentive Payee Company Name: (Pacific Lifestyle Homes ----I u Is this payment redirected?: No Builderor 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 1Solar ReadyVerifier IncslNo Site Information Development Willow Brook Lot �19h.r°Axis ID: IREM/Rate®ID Address 16320 SW 113TH AVE Street Line 2 Multi-Family [No City: TIGARD State: OR Zip 97224 Total conditioned area(sq.ft.): 2 House Volume: I 25.412 Housing Type: Detached single family Number of Stones: 12 Number of Bedrooms: 3 Foundation Type: Crawlspace Electric Provider. Portland General Electric Gas Provider NW Natural Gas Solar installed 0 Solar 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- Framed Floor R- 30.0 Secondary Framed Floor R- Insulation - Above Grade Wall Insulation R- 21.0 Below Grade Wall Insulation R- Flat Ceiling Insulation R- 38 Vaulted Ceiling Insulation R- Windows Windows U- 0.30 SHGC:I0.3 Total window area ' Cooling Air Conditioning SEER: Model 8 Primary Heating System Details AFUE, 0 Brand Trane Type: Electric Heat Pump-Air Source Ducted HSPF. 9 Model#: S9X2B060D3PSAAA Heating Fuel: Electric SEER. 14 Primary Heat : Source Comment COP: Location: Garage or ope Outdoor Unit(for heat pumps) ECM: No Model#: 1RPt436AD1 AHRI Certificate 7889783 #of Systems It Gallons: 150 Brand: Rheem Water Heater Type Storage EF. I.60 Model 6 PROG50-38NRH 60 Water Heating Fuel Gas Location: 'Garage or ope AHRI Certificate: Ducts and Duct Location 'Unconditioned %ducts inside 10% 'i'Duct Leakage(CFM)©50Pa 104 Testing Infiltration Air Changes per Hour(ACH) 50Pa. 4.33 Ventilation Ventilation Type HRV/ERV Model Supply Side-Air Cycler Airflow measured or why untestable? (Roof Termination Appliances Refrigerator kWh/yr Model. ENERGY STAR Diswasher kWh/yr Model. Percent High Efficacy Interior Lighting(%) 100% Thermostat Showerhead 1.5 GPH I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I Notes: