FORM 300-2008

Effective ____________

CHANGE REQUEST FORM

Building Energy Rating System

Rule 9B-60

                 Florida Department of Community Affairs

                         2555 Shumard Oak Blvd.

                     Tallahassee, Florida 32399‑2100

                              (850)487-1824

---------------------------------------------------------------------------

ITEM No.  SHEET  of IMPACTED SUBSECTION __________   __________

Date

NAME   _____________      __________________ __PHONE____________________

ADDRESS            ____________________     ZIP                  ____

Line Through Material to be Deleted Underline Material to be Added

Check One:     Revise subsection to read as follows:

 Add a new subsection to read as follows:

 Delete subsection without substitution:

 Delete subsection and substitute the following:

===========================================================================

REASON  (Attach complete documentation to this form):