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FORMS <br /> FLORIDA 89001MG CODE, ENERGY CONSERVATION <br /> Residential Building Thermal Envelope Approach <br /> FORM R402-2017 Climate tone 13 <br /> Scope:Complia7ce MN Section R4011.2(1)of the Florida Building Code, Energy Conservation,shall be demonstrated by the use of Form <br /> F4402 for single-and multiple-family residences of three stories or less In height,additions to existing residential buildings,alterations, <br /> renovations and building systems in existing buildings,as applicable.To complyi a building must meet or exceed all of the energy efficiency <br /> requirements on Table R402A and all applicable mandatory requirements summarized in Table R402B of this form.If a building does riot <br /> comply with this method,or by the UA Alternative method,It may still comply under Section R405 of the FlorVe Building Code,Energy <br /> Conservation. <br /> PROJECT NAME BUILDER, <br /> AND ADDRESS: <br /> PERMITTING OFFICE:OWNER: /15 <br /> JURISDICTION NUMBER,& <br /> PERMIT NUMBER: <br /> General Instructibns: <br /> 1.Fill in all the applicable spaces of the"To Be I'ristailed"column on Table R402A with the information requested.Al 4'ro Be Installed"values must be <br /> equal to or more efficient than the required levels. <br /> 2.Complete page I based an the"To Be Installed"column information. <br /> 3.Read the requirements of Table R4028 and check each box to indicate your intent to comply With all applicable items. <br /> 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. <br /> 1. Now construction,addition,or existing building, <br /> 2. Single-family detached or multiple-family attached 2. <br /> 3. If multiple-family,number of units covered by this submission 3, <br /> 4. Is this a worst cased(yWno) 4. <br /> a. Conditioned floor area(sq.ft.) 51 <br /> 6. Windows,type and area <br /> a) I.Alaofor. 6e. <br /> Wj Solar Heat Gain toefftisnt(SHGC). 6b. <br /> a) Area 6c. Ce a <br /> 7. Skylights <br /> a) LI-factor, 7a. <br /> b) Solar Heat Gain doeftlent(SHGC) 7b. <br /> S. Floor type,area or perimeter,and Insulation: <br /> a) Slab-on-grade(FPvalue) ea. <br /> b) Wood,raised(R-value) 8b. <br /> c) Wood,common(F?-value) so. <br /> d,N Concrete,raised(A-value) 8d. <br /> e) Concrete,common(FPvafue) 80. It <br /> 9. Wall type and Insulation:a) Exterior. 1. Wood frame(Insulation R-value) Sal. <br /> 2. Masonry(insulation R-value) 9a2. <br /> b) Adjacent: 1. Wood frame(Insulation R-valua)- 9b1. ZJ5 <br /> 2. Masonry(Insulatfon.z?-value) 9b2. <br /> 10. Ceiling type and insulation <br /> a) Attic(Insulation R-value) l0a. <br /> b) Single assembly(Insulation Pvalue) 10b. <br /> 11. Air distribution system. <br /> a) Duct location,Insulation lls. <br /> b) AHU location rlb. <br /> c) Total duct leakage.Test report attached. .1'. Cfm/100 sJ. yes 13 No 13 <br /> 12, Cooling system, a)type. 12a. <br /> b)efficiency <br /> 13, Healing system: a)typo 13a' <br /> b)dtfid ency 13b. <br /> 1 <br /> 14. HVAC sizing calcutatio n:attached (4. _Yes 13 No[I <br /> 15, Water heating system: a)type 158. 51 <br /> b)elfflciency 15b. <br /> I hereby certify that the plans and,:,913F Iffrations covered by this form are Review of plans and specifications covered by this form Indicate <br /> o-wit a in compfiand ,do,Energy Con ry on compliance with the Florida Building Code,Energy Conservation.Before <br /> Cod <br /> e, construction Is clornpla":&,this building will be inspected for compliance In <br /> . <br /> PREPARED SY; <br /> I hereby certify that this buildiro is j4drnplianc- -- the daSulld;ng, accordance with Sao 3.908,F.S. <br /> Code,.Energy Conservation. CODE OFFICIAL: <br /> OWNEPJAGENT; Data:_ Date; <br /> FLORIDA BUILDING CODE-ENERGY CONSERVATION,6th EDITION(JAN 3 '2019 R-66 <br />