13-452-045F'. -RMS
FLORIDA BUILDING CODE ENERRGY CONSERVATION
FORM 402 -201.0 Residential Building Thermal Et7?relope Approach ALL CLIMATE ZONES
Scope: Compliance with Section 402 of the Florida Building Code, Energy Conservation, shall be demonstrated by the use of Form 402 for single- and multiple - family residences of three
stories or less in height, additions to existing residential buildings, renovations to existing residential buildings, new heating, cooling, and water heating systems in exlstmg buildings, as
applicable.To comply, a building must meet or exceed all of the energy efficiency requirements on Table 402A and all applicable mandatory requirements summarized in Table 402B of this
form. 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.
PROJECT NAME:
AND ADDRESS:
HOUSa REENOVAl IO N
(.420 5•o14• It YE.RR.
. fL.
BUILDER:
PERMITTING Slvrk � I AM 1
OFFICE: - - -- - -
_MIWI
OWNER:
PERMIT NO.:
JURISDICTION NO.:
General Instructions:
1. New construction which incorporates any of the followingg features cannot comply using this method: glass areas in excess of 20 percent of conditioned floor area, electric resistance
heat and air handlers located in attics. Additions < 600 sq. t., renovations and equipment changeouts may comply by this method with exceptions given.
2. Fill in all the applicable spaces of the "To Be Installed" 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 Installed" column information.
4. Read the requirements of Table 4028 and check each box to indicate your intent to comply with all applicable items.
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.
1. New construction, addition, or existing building
2. Single- family detached or multiple - family attached
3. If multiple - family -No. of units covered by this submission
4. Is this a worst case? (yes /no)
5. Conditioned floor area (sq. ft.)
6. Glass type and area: "
a. U- factor
b. SHGC
c. Glass area
7. Percentage of glass to floor area
8. Floor type, area or perimeter, and insulation:
a. Slab -on -grade (R- value)
b. Wood, raised (R- value)
c. Wood, common (R- value)
d. Concrete, raised (R- value)
e. Concrete, common (R- value)
9. Wall type, area and insulation:
a. Exterior. 1. Masonry (Insulation R- value)
2, Wood frame (Insulation R- value)
In. Adjacent:: 1. Masonry (Insulation R- value)
2. Wood Frame (Insulation R- value)
10. Ceiling type, area and insulation:
a. Under attic (Insulation R- value)
b. Single assembly (Insulation R- value)
11. Air distribution system: Duct insulation, location, On
a. Duct location, insulation
b. AHU location
c. Qn, Test report attached (< 0.03; yes /no)
12. Cooling system:
a. Type
b. Efficiency
13. Heating system:
a. Type
b. Efficiency
14. HVAC sizing calculation: attached
15. Hot water system:
a. Type
b. Efficiency
Please Print CK
1. ADD IT I N
2.5•�>Arc�1i l.Y
3. `r
4. N
5. 't2Ga
Ga. _0. (O5
6b. O. 3D
6c. _� _ sq. ft.
7. %
8a. R - IIn. ft.
8b, R= sq.ft.
8c. R = sq. ft.
8d, R = sq, ft.
8e. R= sq. ft.
9a -1, R= 0 "[ sq. ft.
9a -2. R= sq. ft.
9b -1. R= r. ^ sq. ft.
9b -2. R = sq. ft.
10a. R= 3a sq. ft. 426
10b. R= sq. ft.
11a. R= (D _A'[f�
11b. _AG 6 CJ 51i�_"[
11 c.Test report attached? Yes No
12a. Type: DX
12b. SEER /EER: 11?"
13a, Type: ta;Lear2tL
13b. HSPF /COP /AFUE:
14. es No
15a. Type: U�GTVJG fih�K 1J5
15b. EF: . 92
hereby certify that the plans and specifications covered by the calculation are in con•_,pranc,; with the Florida Review of plans and specifications covered by this calculation indicates compliance with the Florida
=nergy Code. ���111 �" Energy Code. Before construction is completed, this building will be inspected for compliance in
accordance with Section 553.908, F.S.
REPARED 8'(: ( -= f �''t ✓ a 11 _ PATE GIi
ff CODE OFFICIAL:
hereby certify that_rpnF building is in compNa'nce with the on asi rgy Code:
7WNERAGENT:dpf_ lJ_ DATE: L?- DATE:___
CA 2010 FLORIDA BUILDING CODE - ENERGY CONSERVATION