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FORMS <br /> FLORIDA BUILDING CODE,ENERGY CONSERVATI�DN <br /> FORM 402-2010 Residentfal Building Thermal Envelope Approach ALL CLIMATE ZONES <br /> Scope:�ompliance with Section 402 oi the florida Building Code,Energy Conservation,shall be demonstrated by the use of Form 402 for single-and multiple-tamily residences of three <br /> stories or less in height,additions to existing resitlential buildings,renovations to existing residential buildings,new heating cooling and water heating systems in existing buildings,as <br /> appiicable.To comply,a building must,meet or exceed all of the energy efficiency requirements on Table 402A and all appiicable mandatory requirements summarized in Table 4026 of this <br /> Torm.If a building does not comply with this method or Alternate Form 402,it may still comply under Section 405 of the Florida Building Code,Energy Conservation. <br /> PROJECTNAME: HE�.M�� �Dfll'("IOAJ gUILDER: �� �"r'�-� �yv�. �y�G • <br /> AND ADDRESS: 7a37 I't�s���� �• pERMITTING <br /> ZC T�i��5 33�( OFFICE: (% Z �„ � � <br /> OWNER: L�Yl[,wa. I�IC��r+�(',..v� PERMIT NO.: 3 �(J JURISDICTION NO.: � !�(p�� <br /> General Instructi ons: <br /> 1.New construction which inoorporates any of the following features cannot comply using this method:glass areas in excess of 20 pe�cent ot conditioned floor area,electric resistance <br /> heat and air handiers located in attics.Additions<_600 sq.tt.,renovatfons and equipmeni changeouts may comply by this method with exeeptions given. <br /> 2.Fill in all the applicable spaces of the'To Be Installed"column on Table 402A with the information requested.Aii"To Be Installed"values must be equal to or more efficient than the <br /> required levels. <br /> 3.Compiete page 1 based on the"To Be Installed"column information. <br /> 4.Read the requirements of Table 402B and check each box to indicate your intent to comply with all applicable ftems. <br /> 5.Read,sign and date the"Prepared By"certification statement at the bottom of page 1 The owner or owners agent must also sign and date the form. <br /> Please Print CK <br /> 1. New construction,addition,or existing building 1, !}c{c�i�ow <br /> 2. Single-family detached or multiple-family attached z. 5j nq(L <br /> 3. If multiple-family-No.of units covered by this submission 3 - <br /> 4. Is this a worst case?(yes/no) 4 N p <br /> 5. Conditioned floor area(sq.ft.) 5 (QCfg �1 <br /> 6. Glass type and area: <br /> a.U-factor gy, ��o S <br /> b.SHGC 6b. • 3� <br /> c.Glass area 6c. 5�.S _sq.ft. <br /> 7. Percentage of glass to floor area 7, g % <br /> 8. Floor type,area or pertmeter,and insulation: <br /> a.Slab-on-grade(R-value) 8a.R= ^�- ��� <br /> lin.ft. <br /> b.Wood,raised(R-value) 8b.R- sq.ft. <br /> c.Wood,common(R-value) 8c.R= sq.ft. <br /> d.Concrete,raised(R-value) 8d.R= sq.ft. <br /> e.Concrete,common(R-value) 8e.R= sq.ft. <br /> 9. Wall type,area and insulation: <br /> a.Exterior: 1. Masonry(Insulation R-value) <br /> 9a-1. R= sq.ft. <br /> 2. Wood frame(Insulation R-value) <br /> 9a-2. R= /_3 �_C�sq.ft. <br /> b.Adjacent: 1. Masonry(Insulation R-value) 9b-1. R c Sq.ft. <br /> 2. Wood frame(Insulation R-value) 9b-2. R=� �sq.ft. <br /> 10. Ceiling type,area and insulation: <br /> a.Under attic(Insulation R-value) 10a.R= Sq.ft. <br /> b.Single assembly(Insulation R-value) 10b.R-� sq.ft. <br /> 11. Air distribution system:Duct insulation,location,Qn <br /> a Duct location,insulation i ia. R= �_ <br /> b.AHTJ location 1�b, <br /> c.Qn,Test report attached(<0.03,yes/no) 11 c.Test report attached? Yes � <br /> 12. Cooling system: y (� <br /> a.Type 12a.Type: ��l,.,l Y�d�. <br /> b.Efficiency 12b.SEER/EER• ��i <br /> 13. Heating system: 13a.Type: ��'� <br /> a.Type 13b.HSPF/COP/AFUE: <br /> b.Efficiency <br /> 14. HVAC sizing calculation:attached 14. Yes �o <br /> 15. Hot water system: <br /> a.Type i5a.Type: �/�_ <br /> b.Efficiency i5b.EF: <br /> I hereby certiy that the plans and specifications covered by the calculation are in compliance with the Florida Review of plans and specitications covered by this calculation indicates compliance with the Florida <br /> Energy Code. Energy Code.Betore construdion is ompleted,this bullding w(II he inspected for compliance in <br /> PREPARED BY -� DATE. � accordance with Section 553.90 .S. <br /> a_�i i� <br /> CODE OFFICIAL. <br /> I hereby certify at ' u' Q isln co I' w�t�tryg Florida Enerqy Code: �� <br /> rn.��:E°�,..,. Cti_ u'�'l�_ DATE: ���I� DATE: �J � <br /> C.4 2010 FLORIDA BUILDING CODE-ENERGY CONSERVATION <br />