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FORMS " FLORIDA BUILDING CODE,ENERGY CONSERVATION FORM 402-2010 Resldential Building Thermal Envelope Approach ALL CLIMATE ZONES Seope:Compliance with Section 402 of the florida 8uilding Code,EnergyConse�vation,shall be demonstrated by the use of Form 402 for single-and multiple-family residences ot three stories or less in height,additions to existing residential buildings,renovafions to existing residential buildings,new heating,cooling and water heating systems in existing buildings,as applicable.To comply,a building must.meet or exceed all of the energy efticiency requirements on Table 402A and all applicable mandatory requirements summarized in Table 4028 of this form.If a bmiding does not comply with this method or Alternate Form 402,it may still comply under Seclion 405 of the Florida Building Code,Energy Conservation. PROJECTNAME: POtwln Res��ense BUILDER: (,� ,�� AND ADDRESS: ,5'��{q �a+ti' �St PERMITTING r,� �e h fhi IIS FI.335�I OFFICE: -� p� Ze Yil��5 OWNER: �� W y` PERMIT NO.: g JURISDICTION NO.: (,� General Instructlons: 1.New construction which incorporates any ol the foliowing features cannot comply using this'method:glass areas in excess ol 20 pe�ent ol conditioned iloor area,electric resistance heat and air handlers located in attics. Additlons<_600 sq.ft.,renovations and eguipment changeouts may comply hy lhis method wlth ezceptians gfven. 2.Fill in all the applicable spaces oi the"To Be Installed"column on Table 402A with the information requested.All"To Be Installed"values must be equal to or more efficient than the required levels. - 3.Complete page 1 based on the"To Be Installed"column information. � 4.Read the requirements ol Table 402B and check each box to indicate your intent to comply with all appiicable items. 5.Read,sign and date the"Prepared By"certitication statement at the bottom of page 1 The owner or owners agent must also sign and tlate the form. Please Print CK 1. New construction,addition,or existing building 1 '� 2. Single-family detached or multiple-family attached 2 S('�.� �� 3. If muitiple-family-No.of units covered by this submission 3 - 4. Is th[s a worst case?(yes/no) 4. �� I 5. Conditioned t�oor area(sq.ft.) 5 !�.�� [�] 6. Glass type and area: a.U-factor 6a. •�� b.SHGC _ 6b. � � a Glass area 6c. sq.ft. 7. Percentage of glass to floor area 7, [O, / 8. Floor type,area or perimeter,and insulation: a.Slab-on-grade(R-value) Ba.R- Iln.ft. b.Wood,raised(R-value) 8b.R= I 3 sq.tt c.Wood,common(R-value) 8c.R= sq.ft. d.Concrete,raised(R-value) - Bd.R= sq,ft. e.Concrete,comn�on(R-value) , Be.R= sq.ft. 9: Wall type,area and insulation: a.Exterior: l. Masonry(Insula[ion R-vulue) 9a-1. R e sq.ft. 2. Wood frame(Insula[ion R-value) 9a-2. R=1_� .S�(�sq,ft. ' b.Adjacent L Masonry(Insulation R-value) 9b-1. R= sq.ft. 2. Woodframe(IitsulationR-value) 9b-2. R=� �(F� sq.ft. 10. Ceiling type,area and insulation: a.Under attic(Insulation R-value) 10a.R= sq.ft. b.Single assembly(Insqlation R-value) 10b.R= .3� s sq.ft. 11. Air distribution system:Duct insulation,location,Qn a.Duc[location,insultuion 11 a. R= b.AHU location 17 b. c.Qn,Test report a[tached(<0.03;yes/no) 11 c.Test report attached? Yes No 12. Cooling system: _ , a.Type ` 12a.Type: 3��I fbn V�tni•Sp�l� b.Efficiency 12b.SEER/EER: �3 13. Heating system: 13a.Type: a.Type 13b.HSPF/COP/AFUE: 7•-1 b.Efficiency 14. HVAC sizing calculation:attached 1a. Yes � 15. Hot water system: ,!� a.Type 15a.Type: ��/ - b.Efficiency 15b.EF: I hereby ceAify lhat the plans and specifications covered 6y th:calculation are in compliance with the Florida Review o1 plans and specificalions covered by ihis caiculation i tate ompliance with the Florida Energy Code. Energy Code.Before constmction is complet , i9 b ing ill bej cted for compliance in i ��iZ'�'� �!D`(� accnrdance wilh Section 553.908,F.S. PREPARED BY�` DATE: / CODE OFfICfAL. I hereby certify thal thl uilding is in co yaneev�h'theflorNa Eoergy Code: �.��C,�r� OWNER AGENT� �i�7 /�i d" 1 DATE: DATE: � � . C.4 2010 FLORIDA BUILDING C E-ENERGY CONSERVATION