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FORMS � _� � FLORIDA BUILDING CODE,ENERGY CONSERVATION FORM 402•2010 ' Residentfal Bulldtng Thermal Envelo e A Scope.Compliance with Section 402 oi the florida Building Code,Energy Conservahon,shaii be demonst ategd bythe u e of Form 402 for single-a d mguR pIM amEy re�s ences ot three applica6feiTo comply at�budiidingnmust mee�t or exceed�all of�the energy efffclen�requ,ements on Tableu402A andea I aepp icabf e�man8datory�re�quir�ements summarized in Table 402 form.If a buildfng does not comply with this method or Alternate Form 402,it may still comply under Section 405 of theFlorlda Building Code,EnergyConservatiane��n buildings,as B oi this PROJECT NAME: 52 BUILDER: AND ADDRESS: 5I �� S-�- PERMITTING f1` � h rl�� I(s OFFICE: � � � r 1 � OWNER: Ob(�p� PERMIT NO.: � 32�/ JURISDICTION NO.: General Instruettons: 1.New construciion which incorporates any of the following features cannot comply using this method:glass areas in excess of 20 pe�cent of conditioned floor area,electric resistance heat and air handlers located in attics.Additions<_600 sq.ft.,renovatfons and equfpmeni ehangeauts may compty by this method with exeepttons given. 2.Fill in all the appiicabie spaces of the"To Be Instailed"column on Table 402A with the information requested.All°To Be Installed"values must be equal to or more efficient than the required levels. 3.Complete page 1 based on the"To Be fnstalled"column information. 4.Read the requirements of Table 402B and check each box to indicate your intent to comply with all applicabie items. 5.Read,sign and date the"Prepared By"certiflcation statement at the bottom of page 1.The owner or owners agent must also sign and date the form. 1. New construction,addition,or existing building Piease Print CK 2. Single-family detached or multiple-family attached 1'� 3. if multfpte-famify-No.of units covered hy this submission 2��- 4. Is thts a worst caseT(yes/no) 3•� 5. Conditioned floor area(sq.ft.) 4•� 6. Glass type and area: 5. a.U-fac[or b.SHGC 6a. c,Glass area 6b. t�� 7. Percentage of glass to floor area s�' �-�-54•n. 8. Ffoor type,area or perimeter,and insulation: 7.,__---__'/o a.Slab-on-grade(R-value) b.Wood,raised(R-vyl¢e) 8a.R= c.Wood,common(R-value) gb R_r�---- lin.ft. d.Concrete,raised(R-value) g�.R_ �_sq.ft. e.Concrete,common(R-value) gd.R� _sq,ft. 9. Wall t 8e.R= -sq.ft. ype,area and insulatton: _sq,ft. a.Exterior: 1. Masonry(Insulalion R-value) Z- Wood frame(Insulation R-value) 9a-1. R= 9a-2. R= sq.ft. b.Adjacent: 1. Masonry(Insulafion R-value) --�-�_sq,ft. Z. Wood frame(Insulation R-value) 9b-1. R= 10. Ceilin 9b-2. R_ _sq.ft. g type,area and insulatlon: --�-- �_sq,ft. a Under atde(Insulation R-value) b.Single assembly(Insulation R-value) 10a.R= s ft. 11. Air distribution system:Duct insulation,location,Qn 10b.R= � _sq.ft. a Ductlocation,insulation b.AHLT]ocation 11a. R= �_ c.Qn,Test nport attached(<0.03;yes/no) ��b• �'�C. - 12. Cooling system: 11c.Test report attached? Yes � a Type b.Efficiency 12a Type;�,'�'(�' 13. Heating system: �2b.SEER/EER•.�_ '__ a�'S'P� 13a.Type: � b.Efficiency 13b.HSPF/COP/AFUE: -� 14. HVAC sizing calculation:attached 15. Hot water system: 14. Yes � a Type b.Efficiency 15a.Type; i5b.EF: - 1 hereby certify that the pians and specificaUans covered by the calculallon are in compliance wlth the florida Review oi plans and specifications covered by th�s ca�ulation indfcates compGance with ffie Flori Energy Code. � I��L��(� Enerpy Code.Before constructfon Is comp eted,�� da PREPARED BY: V Z �'� accoNance with Section 553.9�� l ��be inspected for comptlance in DATE:� ( � I heraby cert(y that th�s bufl�� I �( �mA�� e orida Energy Code: �/y CODE OFFICIAL: OWNER AGENT• O�F�/e p� / _z DATE: (0 DATE: ,7 �- C.4 � �_ , 2010 FLORIDA BUILDING CODE-ENERGY CQNSERVATION