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Report Oregon Residential Specialty Code R408.1 MOISTURE BARRIER ACKNOWLEDGEMENT FORM I, (J02 Y , am the general contractor or the owner-builder at the following address: Site Address: I I clef 6Agy_ 57-- City: 114A PP, OP l7/2, Permit#: t-1STIAOrt '' 0011 SO Subdivision/Lot#: Q® K- / 3 and/or 1/C�t Map and Tax Lot#: hS/ 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: i The ground surface of the under-floor space is covered by a Class I vapor retarder or other approved materials, with IKJoints lapped 12 inches at seams and XI Extending up the foundation walls 12 inches. Signature: Date: 01/ ` e /Se, General o a tor or Own uilder I:1Building\Form\RES-MoistureBarrierAcknowledgement_022018 y t Oregon Residential Specialty Code N1107.2 HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Mg'2O C ' ._0(p ! Jurisdiction: c.- i 1.g,FP Site Address: j t 199 c uo 6AS w (16 J - 'ii -V Subdivision/Lot#: iZ OG(A) /'"�' �0�, and/or �' Map and Tax Lot#: ItA 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: 01 1"6/11> OwnerlGetra Contractor/ thorized Agent Print Name: jc'VY SlApeL -I ' 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. 1:\Building\Forms\RES-HighEfficiencyLightingAcknowledgement_022018 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM 1, .439') -AV Y , am the general contractor or the owner-builder at the following address: Site Address: t 1 L 91 ; - City: l:"egAe 1 1f' 'm m,! Permit#: M'J -zioiq — Subdivision/Lot#: uyx(Low 23 pox. and/or Map and Tax Lot#: • A 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. Signature: Date: off/ e 2ie2 GeneCrl C6ntractor or Owner- uilder I:\Building\Form\RES-MoistureContentAcknowledgement_022018 r : Form 640S 2017 Completion Certification—Site Inspection New Homes Program—Single Family of Oregon To be completed by Verifier CLEAResulf is a Program Management Contractor for Energy Trust of Oregon,Inc. — Payment information Incentive Payee Company Name: [Pacific Lifestyle Homes _ifs this payment redirected? INo Builder or Company: Pacific Lifestyle Homes Redirect to Name: T` Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Com Affordable Housing No ^�` Solar Ready Builder Incentive: No 'Solar ReadyVerifier InccNo Site Information _ Development: Willow Brook J,Lot l23 7Axis ID: 'REM/Rate®ID. Address: 11199 SW GABRIEL ST Street Line 2 Multi-Family INo City: TIGARD State: OR Zip 97224 Total conditioned area(sq.ft.): 1,814 House Volume: I 16,507 Housing Type: Detached single family Number of Stories: 11 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&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:I0.3 Total window area: 1225 Cooling Air Conditioning SEER: 0 Model#: Primary Heating System Details AFIJE: 0 Brand Trane Type: Gas Furnace HSPF: 9 Model#: S9X1B040U3PSABAA `Heating Fuel: Gas SEER: 14 Primary Heat Source Comment: COP: Location: Garage or ope Outdoor Unit(for heat pumps) ECM. No Model#: IRP1436AD1 AHRI Certificate:7889763 #of Systems 11 Gallons: 150 Brand: Rheem Water Heater Type Storage EF: '.60 Model#: PROG50-38NRH 60 Water Heating Fuel Gas Location. 'Garage or ope AHRI Certificate: Ducts and Duct Location 'Unconditioned %ducts inside 10% 'Duct Leakage(CFM)6 50Pa. 58 Testing Infiltration Air Changes per Hour(ACH)6 50Pa 2.8 I Ventilation Ventilation Type HRV/ERV Model: 0 Airflow measured or why untestable? 'Roof Termination Appliances Refrigerator kwh/yr Model: ENERGY STAR Diswasher kWh/yr 270 Model. FFCD2418`^A Percent High Efficacy Interior Lighting(%) 100% Thermostat Showerhead 1.5 GPH I Showerwand 1.5 GPM I Showerhead 1.6 GPH I IShowerhead 1.75 GPH I Notes: • 1 .805398 p v�T BACKFLOW PREVENTER REPORTS y } .y EXISTING REMOVEDREMOVED EI 3 REPAIRED REPLACED OLD S/N PROPERTY NAME W I I I V 6 ! Y 0 100 i' /g PHONE CONTACT NAME PHONE Mgt sW Crabrre1 St- MAILING ADDRESS ) �j CITY e)4 4 (Jl STATE ©/'"' ZIP J Q' !''] 2 Z 4 a PREVENTER ADDRES-SAi -{ 0 C �/ 1 19 4 V C SERIAL# H F .r�3 14 WATER SUPPLIER LIGATION`*Fr O ti- 1'i(g (a r Kos- of �'{J_ o y S t MAKE Fe 10 C 0 MODEL 8 S o SIZE // /l TYPE RP RPDA RPDA-II CV DCDA DCDA-II PVB SVB AVB AG HAZARD PROTECTED PREMISE ISOLATIONA I FIRE SYSTEM BOILER. OTHER APPROVED: ASSEMBLY ON ORIENTATION AIRGAP PIPE SIZE I in Uanrr`a in REDUCED PRESSURE ASSEMBLY PVBA/SVBA INITIALTEST CHECK#1 DOUBLE CHECK AIR INLET CHECK VALVE p ASSE OPENED AT: PRESS DROP: PRESS DROP: CHECK#1 TYPE II MIN SPSID 3 'FAILED INITIAL RELIEF VALVE T # 4O Z J/zo TEST MIN i PSID MIN I Mr' DATE a RESULTS AT: OPEN V LEAKED MMINI PSID 0 OPENED � MmzrslD FULLY SYSTEM PSI CHECK#2 FAILED RELIEF VALVE W>J1L4��'y 2 , �` DID NO"I' DETECTOR METER (! READING: PASSED FAILED — OPEN LEAKED MINI PSID NOTES REPAIRS � Cif i i 0 twt PARTS REDUCED PRESSURE ASSEMBLY PVBA/SVBA TEST AFTER REPAIRS CHECK#1 DOUBLE CHECK AIR INLET CHECK VALVE PRESS DROP: CHECK#1 TYPE II OPENED AT: PRESS DROP: MIN 5 PSID DATE REPAIR TIGHT RESULTS RELIEF VALVE MINI PSID NUN I PSID MIN 1 Ps/ PASSED OPENED AT:_ CHECK#2 OPEN MIN 2PSID FULLY TIGHT FAILED RELIEF VALVE ---- MIN I PAD PASSED FAILED GAUGE SIN OJ C i? q MAKE/MODEL e l 5 - 4S CALIBRATION DATE In completing and submitting this test report,the tester certifies that the assembly was tested and maintained in accordance with all applicable rules,laws codes and regulations of the state and water system using approved testing equipment and approved testing procedures. INTIAL TEST TEST AFTER REPAIRS /r,u 13 9 1'F.S E'lia I NA KE `` TESTER SIGNATURE ef 1 t I S TESTERS CERT# TESTER NAME .7(PRINTED)T ) / TESTER NAME(PRINTED) 1.5 Z 4 3 fiPAL I'I G. hi PHONE# TESTER ADDRESS /' f� �/A TESTER ADDRESS O! t QoIA/ C t / 70 ! 5 EMAIL COMPANY E 444JJ! COMPANY NAME WATER RESTORED? -Ira C J.iiitiivll La d s,t 011VJ REPORT RECEIVED BY(REPRESENTATION OF OWNER) REPORT RECEIVED BY(REPRESENTATION OF OWNER) WHITE-UTILITY COPY • YELLOW-CUSTOMER COPY • PINK-TESTER COPY