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1 FORMS � ' FLORIDA BUILDING CODE,ENERGY CONSERVATION FORM 402-2010 Residentiai Building Thermal Envelope Approach ALL CLIMATE ZONES Scope:Complianoe with Section 402 of the Aorida Building Cbd�En�gy Conse�vation,sh�l be danonstrated by the use of Form 402 for single and multiplefanily residences of three stories or less in haght,additions to existing residenti�bwldings,renovations to existing residential buildings,new heeting,000ling,and water heating systens in oastin buildings,as �plic�le To compiy,a building must me�or e�coaed all of the�ergy�ciency requiranents on Table 402A and�I applicable m�d�requiremait�n��lzed in T�le 4026 of this form.If a bwiding does not comply wnth this me4hod or Alternate Form 402,it mag still oomply under Se�tion 405 of theRor�da Buildi Cbd�EnPr9Y PROJECTNAME. ?�'+�� i5'Fe�^r�Q` , UILDER: �_ __ (/��_l __________ _ AND ADDRESS: :��h?IP�I�� r� PERMI�ING n. I r I` —��1N��.-�—�1\:Y-W==- ) �OFFICE l��T� a� ��p Yl y�'/►I I�� �_---�`'-3�yz�----=--------------T--------------- ------ OWNER: !PERMIT NO �� ;JURISDICTION NO �� General Instructions 1 �w construction which incorporates any of thefoliowing features cannot comply using this mdhod:glass ar�s in excess of 20 t of conditioned floor a�,dectric resistance h�t and air h�dlers located in attics. Additions 5 600 sq.ft.,renovations and equi pment changeouts may comply by this meth with exceptions given. 2.RII in all the�plicablespa�of the"To Be InstallEd"column on Table407Awith the information requested.All"To Be Inst�led"values must be equal to or more�cient than the required leoels. 3.Complete page 1 based on the"To Be Installed"column information. 4.R�d the require�ts of Tabie 4026 and check mch box to indicateyour intent to comply with all applicable items. 5.R�rJ,sign and date the"Prepared By'oertification stffianent�the bottom of pa�e 1 The owner or own�s a3ent must�so sign and date the form. Please Print CK 1 New construction,addition,or existing building 1 /�}U �'��d � � 2. Single-family detached or multiple-family attached 2. �n ��. Q ��i � 3 If multiple-family—No of units covered by this submission 3. /V lA v ✓ 4. Is this a worst case? (yes/no) 4 �d �' 5 Conditioned floor area(sq ft.) 5 �`"�� 6 Glass type and area: � a U-factor 6 a �� b.SHGC 6b e ZS c Gl�s area 6c. ��_sq ft. � 7 Percentage of glass to floor area 7 � % � 8 Floor type,area or perimeter,and insulation a.5lab-on-grade(R-value) 8a.R= � �� lin.ft. � b.Wood,raised(R-value) 8b R=� sq ft. c.Wood,common(R-value) 8c R= �/�� sq ft. d.Concrete,raised(R-value) 8d R=�� sq ft. e.Concre4e,common(R-value) 8e.R=� sq ft. 9. Wall type,area and insulation a.Exterior. 1. Masonry(Insulation R-value) ga_� R=�sjj��sq ft. '✓ 2. Woodframe(InsulationR-value) ga_2. R= sq ft. b.AdjacenC 1. Masonry(InsulationR-value) 9b-1. R= /�/� sq.ft. 2. Woodframe(InsulationR-value) 9b-2. R=� sq ft. 10. Ceiling type,area and insulation a.Underattic(InsulationR-value) 10a.R=�30 sq ft. �� b.Singleassembly(InsulationR-value) 10b R=� sq ft. 11 Air distribution system Duct insulation,location,Qn �, a.D uct location,insulation 11 a. R= �_ ��f G b.AHU location 11b.� IS�/✓!ro {��s/!� ,C '`� c.Qn,Testreportariached(<0.03;ya/no) 11c.Testreport tached? Yes o r✓ 12. Cooling system 12a.Type: (i�)T/��/ ��-sf�� fP�M a.Type 12b.SEER/EER: � b.Efficiency � 13 Heating system: 13a.Type:,�� n y h{a��r��U a.Type 13b HSPF/COP/AFUE:�y�'� b.Efficiency � 14 HVAC sizing calculation attached 14 Yes �o 15 Hot water system io)�,� ��1� ,F�1 j,5 f�q y /,�, 15a.Type: �y � a.Type 15b EF ar/ /�' b.Efficiency I F�Eby certify thd ttre pl covaed by the dcvl�ion ae in compli th the Forida �Revie.v of plats ad s�cdims o�vaed by this ail�ion indrdes canplia�cewilh the Forida �� I Er�agy Code.BeFore cons[rud' is cornpl ed, buildng wiil be inspected fw mmpliaxe in � amrdaxewithSection � r � . Pf7�AR�BY: �CCDECH-1qAL I ha�y ify tF�this building is in compliaxewith the Rorida Eiagy Code i �A�: �,,� ��.� 3��I" C 4 2010 FLORIDA BUILDING CODE—ENERGY CONSERVATION