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Master Permit No.
Section A (General Information).
Process No.
Contractors Name: �` ; LIcense # 33 06 2—D
Job Address lt� � �SA� ( 13 _1
❑ Low Slope
❑ Asphaltic Shingles
❑ New roof ❑ Repair
Low Slope Roof Area (SF)
ROOF CATEGORY
❑ Mechanically Fastened Tile ❑ Mortar/Adhesive Set Tiles
*Metal Panel/Shingles ❑Wood Shingles/Shakes
❑ Prescriptive BUR-RAS 150
ROOF ROOF TYPE.
❑ Maintenance *Reroofing
ROOF SYSTEM INFORMATION
Steep Sloped Roof Area (SF) J3 1-+
❑ Recovering
Total (SF)? 1
Section B (Roof Plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include
dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets.
Res
op
mm
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L 1
Section D (Steep Slope Roof System))
Roof System Manufacturer: �Ml emel
Notice of Acceptance Number: 1 L
1 '�0 77 — V—
Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations):
Zone 1:"Lv Zone 2e: Zone 2n: Zone 2r: Zone 3e: Zone 3r:
Deck Type: i f
Type Underlayment:
Roof Slope:
12 Insulation: P
Fire Barrier: �� I
Rsdge Vent ifat%ton? Fastener Type &Spacing: � �C r� �`
Adhesive Type:
Type Cap Sheet: %-1^
Mean Roof Height: Roof Covering: v�
t
Type & Size Dri
Edge: