Report (3) Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
I, Jbi21` gL EL( , am the general contractor or the owner-builder
at the following address:
Site Address: I NS S SO 6 A r-LCL
City: .L A1`-V/ O 1lif
Permit#: S t i 9 — oe-....)37 /
Subdivision/Lot#: O j::_ h i
and/or
Map and Tax Lot#: 0/
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:
fit The ground surface of the under-floor space is covered by a Class I vapor retarder or
other approved materials, with
IXJoints lapped 12 inches at seams and
XExtending up the foundation walls 12 inches.
Signature: / Date: (J G�� to
General nt r Owner-Build
1:\Building\Form\RES-MoistureBarrierAcknowledgement_022018
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 3 P V 14ELY , am the general contractor or the owner-builder
at the following address:
Site Address: I I '15 3 S iJ C/Ag'rtEI ST
City: 1-1.4 iQ(9 or_ T t%'1
Permit#: Si 04731
Subdivision/Lot#: 1 L
and/or
Map and Tax Lot#: h(��
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: U 1 11)
Ge4444ntractor or Ow r-Builder
1:\Building\Form\RES-MoistureContentAcknowledgement_022018
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 00"3-1 Jurisdiction: Cit -TIM
Site Address: j 5 ) A ,. S C _-r1 izo
Subdivision/Lot#: L � goKi i
and/or
Map and Tax Lot#: Y, ,A
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 I 1 b 1 I
Own era Contractor/A orized Agent
Print Name: V 017l gt1r-CL'
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-HighEfficiencyLightingAcknowledgement_022018
Form 640S 2017
Completion Certification—Site Inspection
New Homes Program—Single Family p
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 Its 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 ReadyVerifier Inc No
Site Information ('
Development. Willow Brook iLot Axis ID. I REM/Rate®ID:
Address: 41463 SW Ati ,L:ST 413kt,
Street Line 2 Multi-Family No 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: I1 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-
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- 49.0 Vaulted Ceiling Insulation R-
Windows Windows U- 0.3 SHGC:I0.3 Total window area: 1225
Cooling Air Conditioning SEER: 0 Model#: 4TTR3024H1000NA
Primary Heating System Details AFUE: 0 Brand Trane
Type: Gas Furnace HSPF: 9 Model# S9X2B040U2PSABA
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:7889783 #of Systems 11
Gallons: I50 Brand: Rheem
Water Heater Type Storage EF: I.60 Model#: PROG50-38NRH 60
Water Heating Fuel Gas Location: 'Garage or ope AHRI Certificate:
Ducts and Duct Location 'Unconditioned %ducts inside: Ia`,11_:, 'Duct Leakage(CFM)@ 50Pa: 171
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 3 39 I
Ventilation Ventilation Type HRV/ERV Model:
p Airflow measured or why untestable? (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 I Showerwand 1.5 GPH I Showerhead 1.6 GPH I IShowerhead 1,75 GPH
Notes: