Report p STREET TREE
TIGARD CER TIFICA TIO
N
I, -Sere" (Wsort - or /Y�r'ent f SS b� w �J�ho ��(PL.EASEowner/agent
g
(PERMIT HOT DER)
do hereby cert 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.: ,1f- '3,o 17 N--- 00 333
SITE ADDRESS: 11H 1 LI 5 1 c�
SUBDIVISION: 13 ,•0 ✓he./3-r!ocJ LOT#:
SIGNATURE: DA1E: ( — l
(OWNER/AGENT)
RECEIVED &
VERIFIED BY: Arki`e.;‘, ci'11 -- (4 DATE: E - g - 18
(CITY OF TIGARD)
L51Tree location verified per approved site plan.
I:\Building\Forms\StreetTreeCertificate 05/30/2012
Oregon Residential Specialty Code 8408.1
1l�IOISTTURE BARRIER ACKNOWLEDGEMENT FORM
S%1J /o h op\�S t--) , am the general contractor or the owner-builder
at the following address:
Site Address: 1 ( I 1 [�
.5v Zpynn_c_
City:
Permit#:
�hsf 9.0 i 7 -- 00 355-
Subdivision/Lot#: _ J
�.SS 70 n ✓yl��-t®c�� / L.C3't-
and/or
l
Map and Tax Lot#:
To conform with the 2014 Oregon Residential Specialty Code(ORSC), Section 8408.1
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:
he ground surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
Joints lapped 12"at seams and
xtending up the foundation walls 12".
Signature: Date:
3-10.
General C• tractor o Own -Builder
I:\Building\Form\RES-MoistureBarriencloc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: ni s L n i 7 _ Q o 355 Jurisdiction: t j3 ask co
Site Address: // CI CI f [J c /
Subdivision/Lot#: �n
/r!/3Sr*0� ill C.ado u-)....S
and/or
Map and Tax Lot#: t-,O rf°–
,ik- 6:,
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:
—1 e —1
Owner/a eneral C•'tractor/Authorized Agent
Print Name: -J e.,iOC--1 so r\
'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.
IABuildingTonns\RES-HighEfficiencyLighting.doc 07/01/08
SrU/ `7 - O 3S3- /i 4 i y Sp 3-0zANAl'i; PZ—
Form 6405 2017
Completion Certification—Site Inspection
New Homes Program-Single Family E n e rgyTru s t
To be completed by Verifier of Oregon
CLEAResult is a Program Management Contractor for Energy Trust of Oregon,Inc.
Payment Information `
Incentive Payee Company Name: (Performance Insulation and Energy `
Builder or Company: Mission Homes NW,LLC Its this payment redirected?: I
Verifier Payee Company Name: Performance Insulation and Energy Redirect to Name:
Redirect Payee Com'
Affordable Housing No
Solar Ready Builder Incentive: Solar Read
yVerer Ince'
Site Information
Development Mission Meadows Lot Axis ID: I IREMIRate®ID:
Address: . ',. ..
Street Line 2 Multi-Family No City: TIGARD
Total conditioned areas.ft.: State: OR Zip: 97223
(q ) House Volume: 30,642 Housing Type: (Detached single family
Number of Stones: 12 Number of Bedrooms: 5
Foundation Type: Crawlspace
Electric Provider: Portland General Electric
Gas Provider: INW Natural Gas
Solar installed
Solar Installer Name/Company:
Blue shaded fields are required for EPS sheet
Verification Type Actual Model Equipment Dotage 8 Notes
Slab Perimeter Insulation R- 0.0 Slab Under Insulation R-
Insulation Framed Floor R- 30.0 Secondary Framed Floor R- 59.0
Above Grade Wall Insulation R- 23.0 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: 1458
Cooling Air Conditioning SEER: 0
Model#:
Primary Heating System Details AFUE: 95 Brand Ruud
Type: Gas Fumace HSPF: Model#: R95PA0851521MSA
Primary Heat Heating Fuel: 'Gas SEER:
Source Comment: COP:
Location: Garage or ope Outdoor Unit(for heat pumps)
ECM: No Model#: I -
AHRI Certificate:6465001 #of Systems 11
Gallons: I Brand: AOSmith
Water Heater Type !Heat Pump EF:
Water Heating Fuel Electric I Model HPTU-80N 120
Location: (Garage or ope AHRI Certificate:
Ducts and Duct Location 'Unconditioned %ducts inside:
Duct Leakage(CFM)@ SOPa:
Infiltration Air Changes per Hour(ACH)@ 50Pa: 12.51 I ,
Ventilation Ventilation Type 'Airflow
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.
New Water Heater Model:New Subdivision