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FORMS I FLORIDA BUILDING CODE, ENERGY CONSERVATION n Residential Building Thermal Envelope Approach 0 FORM R402-2017 Climate Zone ❑ Scope:Compliance with Section R401.2(1)of the Florida Building Code,Energy Conservation;shall be demonstrated by the use of Form 0 R402 for single-and multiple-family residences of three stories or less in height,additions to existing residential buildings,alterations, renovations and building systems in existing buildings,as applicable.To comply,a building must meet or exceed all of the energy efficiency requirements on Table R402A and all applicable mandatory requirements summarized in Table R402B of this form.If a building does not comply with this method,or by the UA Alternative method,it may still comply under Section R405 of the Florida Building Code,Energy 0 Conservation. PROJECT NAME Nt_)k Sg BUILDER: OW E AND ADDRESS: ,3L137L 9 9'`�-4gF /V ,Q / / E OWNER: Z�P�YRfflLGS FG. 335_V2 PERMITTING OFFICE: e l�Pr�� GLcI (] < JURISDICTION NUMBER: (p[L O'OffN )l DONI Ill- A-/VAFR-54R) PERMIT NUMBER: General Instructions: 1.Fill in all the applicable spaces of the"To Be Installed"column on Table R402A with the information requested.All"To Be Installed"values must be equal to or more efficient than the required levels. 2.Complete page 1 based on the"To Be Installed"column information. 3.Read the requirements of Table R4029 and check each box to indicate your intent to comply with all applicable items. 4.Read,sign and date the"Prepared By"certification statement at the bottom of page 1.The owner or owner's agent must also sign and date the form. I 1. New construction,addition,or existing building 1. 2. Single-family detached or multiple-family attached 2. �51',n4E 3. If multiple-family,number of units covered by this submission 3. 4. Is this a worst case?(yes/no) 4. O 0 5. Conditioned floor area(sq.ft.) 5. 6. Windows,type and area /l a) Lffactor: 6a. •7 0 /3 l;l. a b) Solar Heat Gain Coefficient(SHGC) 6b. a6_min. c) Area 6o. R 7. Skylights (I a) U-factor: 7a. N/1 b) Solar Heat Gain Coefficient(SHGC) 7b. 8. Floor type,area or perimeter,and insulation: 0 a) Slab-on-grade(R-value) 8a. b) Wood,raised(R-value) Sb. a c) Wood,common(R-value) 80. d) Concrete,raised(R-value) 8d. e) Concrete,common(R-value) 8e. Q 9. Wall type and insulation: 8 a) Exterior: 1. Wood frame(Insulation R-value) 9al. R-�3 2. Masonry(Insulation R-value) 9a2. b) Adjacent: 1. Wood frame(Insulation R-value) 9bl. 2. Masonry(Insulation R-value) 9b2.10. Ceiling type and insulation a) Attic(Insulation R-value) 10a. R-3 D b) Single assembly(Insulation R-value) i0b. 11. Air distribution system: a) Duct location,insulation iia. ie, B b) AHU location lib. EXI 5T/V6 c) Total duct leakage.Test report attached. 110. cfm/l00 s.f. Yes❑ No Zr 8 12. Cooling system: a)type 12a. EXIST/NCv b)efficiency 12b. 13. Heating system: a)type 13a. FJC r 577AAL1, b)efficiency 13b. Qi 14. HVAC sizing calculation:attached 14. Yes❑ No® 8 15. Water heating system. a)type 15a. R` b)efficiency 15b. 1 hereby certify that the plans and specifications covered by this form are Review of plans and specifications covered by this form indicate in compliance with pre Florida Building de, nergy Conservation. compliance with the Florida Building Code,Energy Conservation.Before 0 PREPARED BY: ? Date 6-/8-r8 construction is complete,)this ilding will be inspected for compliance in 1 hereby certif that thi uilding is in compliance with the Florida Building accordance with Secti 3 ,F.S. Code,Energy Conservation. CODE IC L: OWNER/AGENT: Date: Date: - 0 I FLORIDA BUILDING CODE-ENERGY CONSERVATION,6th EDITION(2017) R-55