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;� �j' FORMS <br /> � FLOR/DA BUILDlNG CODE, ENERGY CONSERVATION <br /> I Resirlentsai Builai9ng Tt�errnal Es�vef�a�Approach <br /> FORM R402-2014 Climate Zone ❑ <br /> Scope:Compliance with Section R402.1.1 of the Florida Building Code,Energy Conservation,shall be demonstrated by the use of Form R402 <br /> forisingle-and multiple-family residences of three stories or less in height,additions to existing residentiai buildings,alterations,renovations, <br /> and builrling systems in existing buifdings,as applicable.To comply,a building must meet or exceed ali of tha energy efficiency requirements <br /> on�'able R402A and all applicable mandatory requirements summarized in Table R4026 of this form.If a building does not comply with this <br /> me,thod,or by the UA Alternative method,it may still comply under Section R405 of the Florida Building Code, Energy Conservation. <br /> PRQJECT NAME: �Q 83� .�y.� �VE BUILDER: V ��/ <br /> ANDI ADDRESS: p Q O I�.'��-� � / � �7� <br /> OWNER: ��,P�(z4�1 L,LS� F�-• �3$y2' PERMIiTING OFFICE: G,� ���`�f"���� <br /> JURISDICTION NUMBER: fQ 1 �b0� <br /> PERMIT NUMBER: O <br /> Ge�eral Instructions: <br /> 1.FIII ifl�11 tfla eppti�abl�apa�e�04 t��"Ta Se lnetaited"column on Teble A402A with the Infiormation requesled.All'To�e installed"valuea must be <br /> equel to or more efficient than the requtred levels. <br /> 2.Complete page 1 based on the"To Be Installed"column Informatlon. <br /> 3.Read the requlremente of Table R402B and check each box to Indicate your intent to comply with ell appllcable Items. <br /> 4.i ead,slgn and date the"Prepared By"certi}icetion stetement at the bottom o}page 1.The owner or owner's agent muat also sign and dete the form. <br /> 1. New conat►uction,additlon,or existing bullding 1, ' <br /> 2. Sfngle-femtly detached or multiple-femily attached 2. ��Q <br /> 3. If muitiple•famlly,number of unfts covered by thls submission 3. <br /> 4. Is this a worst case?(yes/no) 4. O <br /> 5. Conditioned floor area(sq.ft.) 5• ��?�. <br /> 6. Windows,type and area ,p <br /> a) U-factor: 68, . �i O <br /> b) Solar Heat Gafn Coefficient(SHGC) 6b. � 25 <br /> c) Area 6c. <br /> 7. Skylights <br /> a) U-factor 78, <br /> b) Solar Heat Gain Coe�cient(SHGC) 7b. <br /> 8. Floor type,area or perimeter,and insulation: - 1 <br /> a) Slab-on-grade(R-value) 8a. �4 � <br /> b) Wood,rafsed(R-value) 8b. <br /> c) Wood,common(R-value) 8c. <br /> d) Concrete,raised(R-vatue) 8d. <br /> e) Concrete,common(R-value) ee. <br /> 9 Wall type and lnsulatlon: <br /> a) Exterior: 1. Wood frame(Insulation R-value) 9a1. �� <br /> 2. Masonry(Insulation R-value) 9a2. <br /> b) Adjacent: 1. Wood frame(Insuladon A-value) 9b1. <br /> 2. Masonry(Insulation R-value) 9b2. <br /> 1U. Cfliling typa end Insuletlon • <br /> a) Attic(Insulation R-value) 10a. � � �� <br /> b) Single assembly(Insulation R-value) 10b. �i <br /> 1 . Air distributlon syatem: I <br /> a) Duct lacation,insulation 11a. LA <br /> b) AWU iocation 11b, <br /> c) Totel duct leakage.Test report ettached. 11c. cfmM00 s.f. Yes� No� <br /> 1 . Cooling system: a)tyPe 12a. � :��C. <br /> b)eificiency 12b. <br /> 1 . Headng syatem: a)tyPe 13a. l_EL.7'�L\ �. <br /> b)effiofency: i3b. � .� <br /> 1 i. HVAC afzing ceiculatlon:attached 14. Yes Q No� <br /> 15. Weter heatfng system: e)type 15a. �l-��.T'2�� <br /> b)efliciency 15b. -�� <br /> I ereby certify that the plans and speciflcatlons covered by this fortn are Review of piane and speclfications covered by this form indfcate <br /> In complienc I t ���JQN u Id/ 6Eod,� rgy ConserveHon. com Ilance w(th the Florlda Bulldln Code Ene Conservatlon.Before <br /> i =y-e �,/� �'��, "��� P 9 , rBY <br /> PREPARED va• p�-�»°����y ate��P � �o construction la complete,thls buildl ill be inspected for compllance in <br /> 1�ereby ceAify that thi 1 g fa i an with the Floride Buiiding accordance with Sectio 3 8, . <br /> Code,Energy Co e ation� Q �7p, CODE 1 IAL: � <br /> OWNER/AOENT: ^ Dete:y�-�� Date: ��`� <br /> FLIORIDA BUILDING CODE-ENERGY CONSERVATION,5th EDITION(2014) R-C.3 <br />