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FORMS � � FLORIDA BUILDING CODE,ENERGY CONSERVATION � FORM 402-2010 Residential Building Thermal Enveiope Approach ALL CLIMATE ZONES Scope:Compliance wfth Sectlon 402 oi the flo�ida Building Code,EnergyConseruatlon shall be demonstrated by the use of form 402 for s(nple-and multiple-family residences of three stories or less in height,additions to existlng residerrtfal bulldings,renovations ta exist�ng residential buildings,new heating cooling and water heating systems in exisUng butldings as applicable.To comply,a buitding must.meet or exceed all of the energy efflciency requirements on Table 402A and ail applipble mandatory requirements summarized in Ta61e 4028 o{this form.If a building does not comply w�th this method or Alternate Form 402,it may still comply under Section 405 of the florida 8uilding Code,EnergyConservatJon. PROJECT NAME: �OL1.0 (�d.(✓�p� �VQ� BUILDER: AND ADDRESS: �e.piny r In�'�5��(�, OFF CE:ING � L �. Q 2'l� S OWNER: �p�-4- �aU la PERMIT NO.: I3 �� JURISDICTION NO.: � General Instructinns: 1.New constructlon whfch incorporates any of the foliow(ng features cannot comply usinp this method:glass areas in excess of 20 peaent of conditioned floor area,eiectric resistance heat and air handlers located in attics.Addltions 5 60D sq.ft.,renovatlons and equfpment changeouts may comply by this method with exceptions given. 2.Fill in ail the applicable spaces of the'To Be Installed°column on Table 402A with the information requested.All"Ta Be Instalied"values must be equal to or more e�cient than the required Ievels. 3.Complete page 1 based on the"To Be Instalied"column fnfortnatfon. 4.Read the requirements of Table 4026 and check each box to(ndicata your fntent to comply with all applicable items. 5.Read,sign and date the"Prepared By"certification statement at the bottom of paqe 1.The owner or owners agent must also sign and date the form. Piease Print CK 1. New construction,addition,or existing building 1. 2. Single-family detached or multiple-family attached � 2.�3. If multipfe-family-No.of units covered by this submission 3. �-- 4. Is thts a worst case?(yes/no) � 4. 5. Conditfoned floor area(sq.ft.) 6. Glass type and area: 5' a.U-factor b.SHGC �a• ' S m . c.Glass area sb• ��r1 • 6c. sq.ft. 7. Percentage of gtass to floor area 7.�_a 8. Floor type,area or perimeter,and insulation: �° a Slab-on-grade(R-value) �q^ b.Wood,raised(R-value) $a•R°� < <+ lin.ft. c.Wood,common(R-value) 8b•R= _sq.ft. d.Concrete,raised(R-value) 8C•R= _sq.ft. e.Concret�,common(R-value) $d•R= _sq.ft. Se.R= _sq.ft. 9. Wall type,area and insulatton: a Exterior: 1. Masonry(Insulation R-value) 2. Wood franie(Insulation R-value) 9a-1. R= � �� sq,ft. 9a-2. R= t` � sq.ft. b.Adjacent: I. Masonry(Insulation R-value) 2. Woodframe(InsulafionR-value) 9b"1• R=� �sq.ft. 9b-2. R- 10. Ceiling type,area and insulation: - sq.ft. a.Under atdc(Insulation R-value) �� b.Single assembly(Insuladon R-value) 10a.R=�o _sq.ft. 11. Air distribution system:Duct insulation,location,Qn 10b.R= _sq,ft a.Duct location,insulation 11 a. R= �j . � �_[,� b.AHLT]ocation 11 b .�}�[� c.Qn,Test report aztached(<0.03;yes/no) 11 c.Test report attached? Yes � 12. Cooling system: �'�° 12a.Type: b.Efficicncy 12b.SEER/EER• - 13. Heating system: - ��,p� 13a.Type: 3 a� b.Efficiency 13b.HSPF/COP/AFUE: 14. HVAC stzing calculation:attached 15. Hot water system: 14. Yes � a.Type 15a.Type: N�At' b.Efficiency i5b.EF• - I hereby cartify thffi the plans and spec(flcatlons covered hy the calculaHan are in compltance wfth the Rorida Review of plans and spedfications covered by this cakulatlon indicates comp0ance wftli the Flarida Enerpy Code. Ener Code.Before const L �1' r4CNon is complete thi buildinp wip be tnspected for complfance in PREPARED BV: � � ,�A G��'�j 'Z accordance with Sectlan 5 D8 DAiE: ! �'.� I heraby certiry th thi d is In co e the jlodda Eneryy Code: / j� CODE OFFICIAL � OWNERAGENT, ! DATE:�0/�+ /� DAT• � C.4 2010 FLORIDA BUILDING CODE-ENERGY CONSERVATION