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FORMS FLORIDA BUILDING CODE, ENERGY CONSERVATION Residential Building Thermal Envelope Approach FORM R402-2017 Climate Zone 12 Scope:Compliance with Section R401.2(l)of the Florida Building Code,Energy Conservation,shall be demonstrated by the use of Form 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 Conservation. fl PROJECT NAME a Zu PURA BUILDER: AND ADDRESS: 3'9*35 Laurel Valley 131V4. OWNER: 0,1-k5 PERMITTING OFFICE:CiTy of 7-ephy1r-W 115 7-efliji-Wills, Ft 3351Z JURISDICTION NUMBER: (&dD 1-:P + LAN PA CZUPRYNA PERMITNUMBER: 2-001 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 I based on the"To Be Installed"column information. 3.Read the requirements of Table R402B 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. lj 1. New construction,addition,or existing building I 2. Single-family detached or multiple-family attached 2. 3. If multiple-family,number of units covered by this submission 3. 4. Is this a worst case?(yes/no) 4. B. Conditioned floor area(sq.ft.) 6. Windows,type and area a) U-factor 6a. b) Solar Heat Gain Coefficient(SHGC) 6b. c) Area 6c. 57q. 6 7. Skylights a) U-factor: 7a. b) Solar Heat Gain Coefficient(SHGC) 7b. 8. Floor type,area or perimeter,and insulation: a) Slab-on-grade(R-value) Be. b) Wood,raised(R-value) 8b. c) Wood,common(R-value) 8c. d) Concrete,raised(R-value) 8d. U a) Concrete,common(R-value) Be. 9. Wall type and insulation: a) Exterior. 1. Wood frame(insulation R-value) Sal. 50k.5 t R-13 2. Masonry(Insulation R-value) 9a2. b) Adjacent: 1. Wood frame(Insulation R-value) Sbl. 4114q.75 it 12-13 2. Masonry(insulation R-value) 9b2. 10. Ceiling type and insulation a) Attic(Insulation R-value) I Be. R- b) Single assembly(insulation R-value) I Ob, R- 11. Air distribution system: a) Duct location,insulation b) AHU location llb. X I 6+i ngq c) Total duct leakage.Test report attached, 11c. _J of m/l 00 S.f. Yes[] No F- 12. Cooling system: a)type 12a. Ex'u5-Finq b)efficiency 12b. J 13. Heating system: a)type 13a. EA i S I>1q b)efficiency I 3b. 14. HVAC sizing calculation:attached 14. Yes[] No R 15. Water heating system: a)type 15a. EX I 11qg FleC. b)efficiency 15b. I hereby certify P' that th plans and specifications covered by this form are Review of plans and specifications covered by this form indicate in compliance with -PFlofidaBui ode nergy Conservation, compliance with the Florida Building Code,Energy Conservation.Before 0 PREPARED By. Date 81-1?-/9 construction is complete,this b ilding will be inspected for compliance in 9 I hereby certify(hat thiaullding is in compliance with the Florida Building accordance with Sefeyq(9 ,F.S. Code,Energy Conservation. CODE OFFICIAL: 0 OWNER/AGENT: Date:- Date: J.: 11 FLORIDA BUILDING CODE-ENERGY CONSERVATION,6th EDITION(2017) R-55