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FORMS FLORIDA BUILDING CODE,ENERGY CONSERVATION FORM 402-2010 Residentfal Building Thermal Envelope Approach ALL CLIMATE ZONES Scope:Compliance wRh Section 402 oi the Florida Building Code,Enerpy Conservation,shall be demonstrated by the use of Form 402 for single-and multiple-family residences ot three stories or less in height,additions to existing residential buildfngs,renovations to existing resider�ial buildings,new heffiing cooling and water heffiinp systems in e�tisfing buildings as applicable.To comply,a building must,meet or e�cceed all of the energy efficiency requirements on Table 402A and all applica�le mandatory requiremerrts summarized in Ta61e 402B of this form.If a buiiding does not comply with this method or Alternate Form 402,it may stiil comply under Section 405 oitheRorida Building Code,fnergyConservation. PROJECT NAME: �'t10N� BUILDER: ,��R,s � ANDADDRESS: 37�cJ� ��n�I PERMffTING � ' �1 1�l l I OFFICE: '° J� � l�S OWNER: PERMIT NO.: JU ISDICTION NO.: �j� �}� Generat Instructions: 1.New construction 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 5 600 sq.ft.,renovattons and equipmeni changeouts may comply by this methad with axceptions given. 2.FlII in all the applicable spaces of the'To Be Instailed"column on Table 402A with the information requested.All"To Be Installed"values must be equal to nr more efficient than the requfred levels. 3.Compiete page 1 based on the"To Be Installed"column information. 4.Read the requirements of Tabie 402B and check each box to indicate your intent to comply wfth ail applicable items. 5.Read,sign and date the"Prepared By"certification statement at the bottom of page 1.The owner or owners ageM must also sign and date the form. Please Print CK 1. New construction,addition,or existing building � �� 2. Single-family detached or multipie-family attached 2 , IhF 3. If multiple-family-No.of units covered by this submission 3 _ 4. Is this a worst case?(yes/no) 4.�O 5. Conditioned floor area(sq.ft.) 5 110� 6. Glass type and area: a.U-factor �FJ 6a. b.SHGC 6 b. •� c.Glass area 6c. Sq.ft. 7. Percentage of glass to floor area a �. 3_ �10 % 8. Floor type,area or perimeter,and insulation: a.Slab-on-grade(R-value) 8a.R-�_ � g0-}jq,n, b.Wood,raised(R-value) 8b.R- c.Wood,common(R-value) 8c R_ _sq.ft. d.Concrete,raised(R-value) _Sq.ft. Sd.R= s ft. e.Concrete,common(R-value) He,R_ -sq.ft. 9. Wail type,area and insulation: a.F�cterior: ] Masonry(Insulation R-value) 9a-1. R- 2. Wood frame(Insulation R-value) S9•n• 9a-2. R=� �_sq.ft b.Adjacent: l. Masonry(Insulation R-value) 96-1. R= Sy,h, 2. Wood frame(Insulation R-value) 9b-2. R=� r ��-.-sq.ft. 10. Ceiling type,area and insulation: a.Under aztic(Insulation R-value) ;�F1 - I�7 0 b.Single assembly(Insulation R-value) 10a.R-s�S� sq.ft._ / 10b.R= _sq.n, 11. Air distribution system:Duct insulation,location,Qn / a.Duct locazion,insuladon 11 a. R=�P b.AFIU]ocafion 11 b. �}�! c.Qn,Test ieport attached(<0.03;yes/no) 11 c.Test report attached? Yes� 12. Cooling system: ��,�� �-'►'YPe 12a.rype:_� .-�/A l� b.Efficiency 12b.SEER/EER.�_ 13. Heating system: 13a .ry�. �Jm a-�'p° 13b.HSPF/COP/AFUE• �_ b.Efficiency 14. HVAC siztng calculation:attached 14. Yes No 15. Hot water system: a�YPe 15a.Type: N�� _ b.Efficiency 15b.EF• I hereby cer�fy that the plans and specifiwtions covered by the calculation are in compliance wtth the Florida Review of pians and spec�cations covered by this calculation(ndicates compfiance with the Florida Enerpy Code. ,� `(� EnerpY Code.Before construction is completed,this buildinp w(II be inspected for compliance In �� I� DATE:�I �Z accordance wRh S n 553.908,F� , PREPARED BY `� I hereby certify th�th'��u�i�n9 is in compllanJ �yl��he��qrid§jnergy Code: p CODE OFfICIAL. OWNERAGENT �+'1L-Q.-C�� G�LtV1��,J/1 pp7E;j �y-�IL DATE: "� ' °• 2! C.4 2010 FLORIDA BUILDING CODE-ENERGY CONSERVATION