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FORh�S . • FLORIDA BUILDING CODE,EN RGY CONSERVATION: FORM 402-2010 Residential euilding Thermal nvelope Approach ALL CLINIATE ZONES Scope:Compliance}vith Section 402 of lhe florida Building Code,Energy Conservation,shail be d monstrated by the use of Form 4021or single-and multiple-family residences ot three stones or less in height,additions to existing Pesidential buildings,renovations to existing residen ial buildings,new heating cooling and vrater heating systems in existing buildings,as applicable.To comply,a building must.meet or exceed all of the energy efficiency requirements on able 402A antl all applicable mandatory requirements summarized in Table 4026 of this form.If a building does not comply with this method or Alternate Form 402,it may still comply un er Section 405 of the Florida Building Code,-Energy Conservation. PROJECT NAME: Tlflef'Df'L BUILDER: u,yl � u ' AND ADDRESS: M0.��,�O�B" St� pERMITTING h r '1 Is FI. 335 OFFICE: OWNER: �-�'j0.i l r)2rOV+ PERMIT NO.: JURISDICTION NO.: I Generallnstructlons: 1 New construction which incorporates any ol the foilowing features cannot comply using this m thod:glass areas in excess of 20 pe�ent ol conditioned floor area,electric resistance heat and air handlers located in attics.Addilions<6U0 sq.ft.,renovations and eguipment chang outs may eomply hy thls method wlth exceptions given. 2.Fill in all the applicable spaces oi the"To Be Installed"column on Table 402A with the informati n requested.AII"To Be Instailed"values must be equal to or more efficient than the required levels. 3.Complete page 1 based on the"To Be Installed"oolumn intormation. 4.Read the requirements oi Table 4028 and check each box to indicate your intent to comply with all applicable Rems. 5.Read,sign and date the"Prepared By°certification statement at the bottom o(page 1 The own r or owners agent must also sign and date the form. Please Print CK 1. New construction,addition,or existing building 1 �Ff��-�-�bn 2. Single-family detached or multiple-family attached 2 j n 3. If multiple-family-No.of units covered by this submission 3 �' 4, !s this a worst case?(yes/no) 4. NO 5. Conditloned floor area(sq.ft.) 5. (G�� [�1 6. Glass type and area: a.U-factor 6a. �•�5 b.SHGC , - fih. O. 30 c.Glacs area 6c. Z� _sq,ft. 7. Percentage of glass to floor area 7. 17 % 8. Floor type,area or perimeter,and insulation: a.Slab-on-grade(R-value) 8a.R= lin.ft. b.Wood,raised(R-value) 8h.R=�_ 140 'sq.ft. c.Wood,common(R-value) Sc.R= sq.ft. d.Concrete,raised(R-value) 8d.R= sq.ft. e.Concre[e,common(R-value) - Be.R= Sq,ft. 9. Wall type,area and insulation: a.Exterior L Masonry(Insulation R-vulue) - 2. Wood frame(Insulation R-value) 9a-1. R= sq.ft. 9a-2. R=�_ 7_5S sq.ft. b.Adjacen[: 1. Masonry(Insulation R-value) 9b-1. R= sq.ft. 2. Wood frame(Insulation R-value) 9b-2. R c�� O �� sq.ft. 10. Ceiling type,area and insulation: a.Under attic(Insulation R-value) 10a.R= ,30 sq.ft. �� Q' b.Single assembly(Insulation R-v11ue) 10b.R= sq.ft. 11. Air distribution system:Duct insulation,location,Qn a.Duct location,insulation 71 a. R c �O b.AHU loca[ion 116. c.Qn,Test report attached(<0.03;yes/no) 11 c.Test report attached? Yes � 12. Cooling system: ' a Type 12a.Type: C P_i'1�fzi.� b.Efficiency 12b.SEERlEER: I 3 13. Heating system; , 13a.Type:_��1 e4f" I�a�v+�A � a.Type 13b.HSPF/COP/AFUE: 7. b.Efficiency 14. HVAC sizing calculation:attached 14, Yes No 15. Hot water system: � a.Type � i5a.Type: /� �' ' b.Efficiency i5b.EF• I here6y certity lhal lhe pl and specificalions covered by the calculation are in compliance vrith the Florida Review of plans and speci(ications covered by lhis calculation indicates compliance with the Florida Energy Code. Energy Code.Before construction is complet d,this 6uilding will be inspected for compliance in accordance vrith Section 55 . 8, .5. . PREPARE�BY• - DATE:_�-o20-r� CODE OFFICIAL I here6y certify that this 6uilding is in compliance with Ihe Florida Energy Cade: - OWNER AGENT• DATE: DATE: >- C.4 2070 FLORIDA BUILDING CODE-ENERGY CONSERVATION