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<br /> � FORMS
<br /> FLORIDA BUILDING CODE,ENERGY CONSERVATION
<br /> FORM 402-2010 Residential Building Thermal Envelope Approach ALL CLIMATE ZONES
<br /> Scope:Compliance with Section 402 of the florida Burlding Code,Energy Conservation,shall be demonstrated by the use of Form 402 for single-and multiple-family residences oi three
<br /> stories or less in height,additions to existing residential buildings,renovations to existing residential buildings,new heating,cooling and water heating systems in existing buildings as ;
<br /> applicable.To comply,a building must meet or exceed all oi the energy efficiency requirements on Table 402A and all applicable mandatory requirements summarized in Table 402B o{this
<br /> form.If a bwlding does not comply with this method or Alternate Form 402,it may still comply under Section 405 of the florida Building Code,Energy Conservation.
<br /> PROJECT INAME: / �e�_ BUILDER: �1�'L�jf��YC�ti..
<br /> AMD ADDRESS: �bJ�Z��� PERMITTING ��_}. � �,��
<br /> OFFICE: � � ,
<br /> OWNER: �i PERMIT NO.: `7 � JURISDICTION NO.: L�
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<br /> General Instructions:
<br /> 1 New construction which incorporates any ot the following features cannot comply using this method:glass areas in excess of 20 pe�ent of conditioned floor area,electric resistance
<br /> heat and air handlers located in attics. Additians 5 600 sq.ft.,renovations and equipment changeouts may comply hy this method with exceptions given.
<br /> 2.Fill in all the applicable spaces of 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
<br /> required level's.
<br /> 3.Complete dage 1 based on the"To Be Installed"column information.
<br /> 4.Read the r�quirements of Table 402B and check each box to indicate your intent to comply with all applicable items.
<br /> 5.Read,signlland date the"Prepared By"certification statement at the bottom of page 1 The owner or owners agent must also sign and date the form.
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<br /> � Please Print CK
<br /> 1. Mew construction,addition,or existing building , � ��������� ���fjJ,��
<br /> 2. Singlie-family detached or multiple-family attached 2 .�o,,��fP�, y
<br /> 3. If multiple-family-No.of units covered by this submission 3 �f�t�,
<br /> 4. Is this a worst case?(yes/no) 4 ��
<br /> 5. Conditioned floor area(sq.ft.) 5 � ^ �
<br /> 6. Glass type and area:
<br /> _ �U-factor 6a. �`��i
<br /> '�b.SHGC 6b. �.�-f _
<br /> , c.Glass area
<br /> i 6c. c�<'�' sq.ft.
<br /> 7. Perc�entage of glass to floor area � f� o�o
<br /> 8. Floo�r type,area or perimeter,and insulation:
<br /> • �i a.Slab-on-grade(R-value) ga,p= ;C/!,� aq�_I'In.ft.
<br /> ' �i b.Wood,raised(R-value) 8b.R= sq.ft.
<br /> ; c.Wood,common(R-value) 8� R=� Sq n
<br /> d.Conctgte,raised(R-value) q
<br /> �, e.Concrete,common(R-value) Be:R_�- Sq ft:
<br /> 1 9. Wall type,area and insulation: • � �
<br /> ' a.Exterior• 1. Masonry(Insulation R-value) � 9a-1. R= ��sq.ft.
<br /> 2. Wood frame(Insulation R-value) ga_2, p= . sq.ft.
<br /> b.Adjacent 1. Masonry(Insula6on R-value) 9b-1. R= '38t� sq.ft.
<br /> 2. Wood frame(Insulation R-value) 9b-2. R- sq.ft.
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<br /> 10. Ceilling type,area and insulation:
<br /> a.Under attic(Insulation R-value) q /d R�
<br /> � b.Single assembly Qnsulation R-value) 10b.R= S ft Sq,n.
<br /> 11. Air�distribution system:Duct insulation,location,Qn
<br /> � a.Duct location,insulation 11 a. R= � �,
<br /> b.AHU location ��b,
<br /> c.Qn,Test report attached(<0.03,yes/no) 11 aTest report attached? Yes No
<br /> 12. Caoling system: /
<br /> a.Type 12a.Type: /�1���7 I
<br /> b.Efficiency 12b.SEER/EER•
<br /> 73. Heatingsystem: ��-�� ,f
<br /> 13a.Type: �� �-1
<br /> �� a.Type 13b.HSPF/COP/AFUE:�
<br /> u b.Efficiency
<br /> 14. HVAC sizing calculation:attached 14. Yes No
<br /> 15. Hilt water system:
<br /> a.Type 15a.Type:
<br /> � b.E�ciency 15b.EF:
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<br /> I hereby�certify tha[the plans and specifications covered by the calculation are in compliance with the Florida Review of plans and specifications covered y this calculation indicates compllance with the Florida
<br /> Energy Codey _ Energy Code.Betore construction is o eted,this building will be inspected for compliance in
<br /> I I�. accordance with Sectio� 8,
<br /> PREPARED BY���Cj,Q�A/L � DA7E; �S �
<br /> CODE OFFICIAL.
<br /> I hereby�l ertify that this building is in compliance with the Florida Energy Code: r�� �/�
<br /> OWNER;AGENT DATE: DATE. � � �
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<br /> C.4 �� 2010 FLORID BUILDING CODE-ENERGY CONSERVATION
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