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Section A (General Information)
er Permit No. Process No.
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ractors Name: License #
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address ' L
Ten
ROOF CATEGORY
anically Fastened Tile ❑ Mortar/Adhesive
iw Slope �Vetal
;phaltic Shingles Panel/Shingles ❑Wood
❑ Prescriptive BUR-RAS 150
ROOF ROOF TYPE_
Jew roof ❑ Repair ❑ Maintenance I!3'lVeroofing
• ROOF SYSTEM INFORMATION
Slope Roof Area (SF) Steep Sloped Roof Area (SF) Z.�2—(1�9
Section B (Roof Plan)
:h Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow
de dimensions of sections and levels, clearly identify dimensions of elevated pressure
Shingles/Shakes
❑
scuppers
zones and
Set Tiles
Recovering
Total (SF) Zr%6
and overflow drz
location of parapi
4
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i
3
'
-
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i
sins.
As.
Section C (Low Slope Roof)
Fill in specific roof assembly components and identify
manufacturer
(If a component is not used, identify as "NA")
System Manufacturer: % f"k - th ►)11a
Product Approval No.:r vj&gQ - gg
Design Wind Pressures,, (From RAS 128 Or Calculations:
Zone 1'' L Zone 1."'& Zone f ti'i� Zone 3:� 91
Max. Design Pressure, from the specific product approval
system: _ Jy4 /e- bbn de k'G i ao 1
Deck:
Type: z4m"'000
Gauge Thickness: lS�3Z
Slope: 0- / //
Anchor/Base Sheet & No. df Ply(s):
Anchor/Base Sheet Fastener/Bonding Material:
Insulation Base Layer: 4442
Base Insultation Size and Thickness:
Base Insulation Fastener/Bonding Material:
Top Insulation Layer:
Top Insulation Size and Thickness:
Top Insulation Fastener/Bonding Material:
Base Sheet(s) & No. of Ply(s):
Base Sheet FXIA�
ner/Bonding Material:
�:zr Fast
Ply Sheet(s)' & No. of Ply(s):
Ply Sheet Fasten er/Bondin Material:
��EWOE E, I I
Top Ply Fasten
Fastener/Bonding Material:
J'e 1p Xj I W
Surfacing:
Fastener Spacing for Anchor/Ba
Zone 1':_._" oc @ Lap, # Roi
Zone 1:—" oc @ Lap, # Rov
Zone 2:_.._." oc @ Lap, # Rov
Zone 3:—" oc @ Lap, # Rov
Sheet Attachment:
® 000
@ ° 00
@ ° 00
Number of Fasteners !Per Insulation Board:
Zone 1': Zone 1: Zo a 2: Zone 3
Illustrate Components Noted and Details as Applicable:
Woodblocking, Gutter, Edge'Termination, Stripping,
Flashing, Continuous Cleat, Cant Strip, Base Flashing,
Counterflashing, Copiing, Etc.,
Indicate: Mean Roof Height, Parapet Height, Height of Base
Flashing, Component Material, Material' Thickness, Fastener
Type, Fastener Spacing or Submit Manufacturers Details that
Comply with RAS 111 and Chapter 16..
Section D (Steep Slope Roof System)
Roof System Manufacturer: C�'t°e"e "e-6d 14- Awkx
Notice of Acceptance Number:
iZ z
Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations):
Zone 1 Zone 2e Zone 2n4LZone 2r: .Zone 3e �;
Deck Type: A
Roof. Slope: Type Underlayment: o4 ,fycy— -Y-tr1JA
12 Insulation:
Fire Barrier:
Ridge V ntilation? Fastener Type & Spacing:
Adhesive Type:
Type Cap Sheet F
Mean. Roof Height: 11 Roof Covering:
Type & Size
Edge:
I