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Home My WebLink About010-034-002r 1 � BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line (IVR) : 530.538.4365 (Cut off time for inspections is 3pm) Development Services cannot guarantee inspections on the date requested Office: 530.538.7601 Fax: 530.538.7785 www.ButteCounty.net/dds Permit No: B17-1949 Issued: 8/25/2017 APN: 010-034-002 Address: 1467 MAGNOLIA ST, GRIDLEY , Owner: LATELY JOHN A & BARBARA J Permit Type: RE -ROOF RESIDENTIAL Description: REROOF 10 SQUARES t AREA 1 Flood Zone: None S! A Area: No SETBACKS for Zoni�yr_ AG_ SRA_ W Front: Centerline of Road: Rear: SRA: Street: AG: Interior Total Setback from Centerline of Road: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 131 Foundations / Footings 111 Pier/Column Footings 122 Eufer Ground 216 Masonry Grout 120 :131 Pool Plumbing Test Do Not Pour Concrete Until Above are Signed Pre -Slab 11,24 404 Gas Test Underground/floor 404 Gas Piping Underground/floor 403 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing - 412 Under Slab Plumbing 411 i612 Tiedown/Soft Set System 161 l Permanent Foundation System Do Not Install Floor Sheathing or Slab Until Above Signed Shearwall/B.W.P.-Interior 134 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Manometer Test 605 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 153 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 4 -Way Rough Framing 128 Gas P'2ing House 403 Gas Test House 404 Shower Pan/Tub Test 408 Do Not Insulate Until Above Signed Permit Final 802, Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Fire Sprinkle r Test or Final 702 Swimmin :?ools Setbacks Inspection Type L'VR INSP DATE T -Bar Ceiling ;145 Stucco Lath !142. Swimmin :?ools Setbacks :131 Pool Plumbing Test .504 Gas Test 404 Pre-Gunite 506 Pre -Deck 505 Pool Fencing/Alarms/Barriers 503 Pre -Plaster i 507 Manufactures Homes Setbacks :131 Blocking/Underpining i612 Tiedown/Soft Set System 161 l Permanent Foundation System :613 Underground Electric :218 Sewer 407 Underground Water ':417 Manometer Test 605 Continuity Test :602 Skirting/Steps/Landings 610 Coach Iifo Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Finals Public Works Final 538.7681 Fire De artment/CDF 538.6226 Env. Health Final 538.7281 Sewer District Final **PROJECT FINAL *Project Final is a Certificate of Occupancy for (Re identiOn ) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED„YOU MAY PAY OR A 1 YE R RENEWAL 30 DAYS PRIOR TO EXPIRATION i 1 BUTTE COUNTY .DEPARTMENT OF DEVELOPMENT SERVICES ' BUILDING PERMIT 24 HOUR INSPECTION (IVR)#:530.538.4365 OFFICE #: 530.538.7601 FAX#:530.538.7785 www.ButteCounty.net/dds . • L i 'r J.»< ![rs: . irai �•i t, i ..1 �'#.' � : � i4 . e,� fy';y,.. Site Address: 1467 MAGNOLIA ST APN: 010-034-002 Permit type: MISCELLANEOUS Subtype: RE -ROOF RESIDENTIAL • Descriotioni RF,RQQF 10 SQUARES )JECT INFORMATION','--, 'V - Owner: GATELY JOHN A & BARBARA 1261 LOSSER AVE. GRIDLEY, CA 95948 F Permit No: B 17-1949, Issued Dare: 8/25/2017 By • DAH Expiration Date: 8/25/2018 Occupancy: Zoning: R2 Contractor - Applicant: ' Square Footage: OWNER BUILDER P' GATELY JOHN A & Building Garage Remdl/Addn 0 0 0 1261 LOSSER AVE .., • GRIDLEY, CA 95948 Other Porch/Patio t Total , 0 0 0 LICENSED CONTRACTOR'S' DECLARATION , . ,' -: =t.::_:: -OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I hereby affirm under penalty of perjury that I am exempt tom the Contractors' State License Law for OWNER BUILDER / / the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section ,. 703 5, Business and Professions Code: Any city or couniy that requires a permit to construct, alter, , improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the Persil to file a signed statement that he or she is licensee pursuant to the provisions of the Contractors' I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter g (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license i State License Law (Chapter 9 (commencing with Section °000) of Division 3 of the Business and in full force and effect. Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. X Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will ❑ Contractor's Signature Date do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the properly, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the �'.`-:}WORKERS'-.COMPENSATION DECLARATION s I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' burden of proving that it was not built orEl compensation, issued by the Director of Industrial Relations as provided for by Section improved for the purpose of sale.). ` 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. ❑ I, as owner of the property, am exclusively contracting with licensed Contra ctorsto the project (Section 7044, Business and,Professions Code: The Contractors' State ❑construct I have and will maintain workers' compensation insurance, as required by Section 3700 of License Law does not apply to an owner of propertywho builds or improves thereon, and who the Labor Code, for the performance of the work for which this permit is issued. My workers' contracts for the projects with a licensed Contractor -pursuant to the Contractors' State License compensation insurance carrier and policy number are: Lam,,), Carrier. Policy Number: Exp. Date: .. - I am exempt from licensure under the Contractors' State License Law for the following ' I certify that, in the performance of the work for which this permit is issued, I shall not El reason: • . employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' X = + compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those - provisions. Owners Signature _ Date X ^•` PERMIPAPPLICANT DECLARATION' "• " ` -ry SignatureDate By my signature below, I certify to each of the following: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS I am L) a California licensed contractor or U the property owner' or U authorized to . UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES act on the property owner's behalfit s I have read this construction permit application wind the information I have provided is AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN correct. ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN I agree to comply with all applicable city and coLhty ordinances and state laws relating SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. California Licensed Contractor, Property Owner' or Authorized Agent": 'requires separate verificatiin form "requires separate • ' r� CONSTRUCTION LENDING AGENCY DECLARATION : I hereby affirm under penalty of perjury that there is a construction lending agency for the authorization form - performance of the work for which this permit is issued (Section 3097, Civil Code). ' lender's Name and Address X of Permittee [SIGN] Print Date , + l -.Name Lender's Name & Address City State Zip i. _• v =-t# " �. #' . ,< <i= gr ;t FEE INFORMATION r 11 Total Fees: $128.00 Fees Paid: $128.00 ' -Balance Due: (None) Job Value: $1,500.00 U i __ 7 ,dr1.• 4. .., • U i __ 7 Butte County Department of Development Services PERMIT CENTER 7 County Center Drive, Oroville, CA 95965 Main Phone (530) 538-7601 Fax (530) 538-7785 www. b u tte co u n ty. n e ttd ds Declaration of Installation for Smoke Alarms and Carbon Monoxide Alarms FORM NO DBI -01 The newly adopted 2016 California Residential Code requires the installation of Carbon Monoxide Detectors in dwelling units and in sleeping units within which fuel -burning appliances are installed and in dwelling units that have attached garages. The policy for Carbon Monoxide Alarms in Butte County states: "Any permit obtained in which the value of work exceeds $1000 associated with a Residential Group R Dwelling Unit or Sleeping Unit shall conform to the following 2016 California Residential Code requirements for Smoke and Carbor. Monoxide Alarms (Section R314 & R315).° 2016 California Residential Code requirements for Carbon Monoxide Alarms: R315.1 New construction: An approved carbon monoxide alarm shall be installed in dwelling units and in sleeping units within which fuel -burning appliances are installed and in dwelling units that have attached garages. R315.1.2 Power supply; For new construction required carbon monoxide alarms shall receive their primary power from.the building wiring where such wiring is served from a' ;ommercial source and shall be equipped with a battery back-up. Alarm wiring shall be directly connected to the permanent building wiring without a disconnecting switch other than as required for over - current protection. Exceptions: 1. In dwelling units where there is no commercial power supply the carbon monoxide a.arm may be solely battery operated. 2. In existing dwelling units a carbon monoxide alarm is permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. R315.1.3 Interconnection. Where more than one carbon monoxide alarm is required to be installed within the dwelling unit or within a sleeping unit the alarm shall be interconnected in a manner that activation of one alarm shall activate all of the alarms in the individual unit. Exception: 1. Interconnection is not required in existing dwelling units where repairs do not result in the removal of wall and ceiling finishes, there is no access by means of attic, bg3ement or crawl space, and no previous method for interconnection existed. R315.2 Where required'in existing dwellings: Where a permit is required for alterations, repairs or additions exceeding one thousand dollars ($1,000), existing dwellings or sleeping units that have attached garages or fuel -burning appliances shall be provided %Mth a carbon monoxide alarm in accordance with Section R315.1. Carbon monoxide alarms shall only be required in the specific dwelling unit or sleeping unit for which the permit was obtained. R315.2.6 Alarm requirements: No person shall install, market, distribute, offer- for sale or sell any carbon monoxide device in the State of California unless the device and instructions have been approved and.listed by the State Fire Marshal. ' Pagel of 2 Revised 12.19.2016 Carbon monoxide alarms required by Sections R315.1 and R315.2 shall be installed in the. following locations: 1. Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedroom(s). 2. On every level of a dwelling unit including basements. ; R315.1.5 Multiple -purpose alarms: Carbon monoxide alarms combined with smoke alarms shall comply with: Section R315, all applicable standards, and requirements for listing and approval by the Office of the State Fire Marshal, for smoke alarms. Butte County's Interpretation of 2016 CRC, Sections 314 & 315 for Smoke Alarms & Carbon Monoxide Alarms: Where alterations, repairs or additions exceeding $1,000 in valuation, existing dwellings shall be retrofitted with smoke alarms and those that have attached garages or fuel -burning appliances shall have carbon monoxide alarms installed. Existing smoke alarms can be replaced with dual function alarms for Smoke and Carbon Monoxide and in most cases will comply with the aforementioned code requirements for Carbon Monoxide Alarms. DECLARATION OF INSTALLATION UNDER THE PENALTY OF PERJURY As Owner/Contractor, I/we affirm and declare under the penalty of perjury, under the laws of the State of California, by our signatures below as Owner/Contractor, that I/we will comply prior to final inspection with Items A & B as specified herein: A. Both Owner/Contractor have read and clearly understand the aforementioned 2016 California' Residential Code (CRC)' Carbon Monoxide Alarm requirements. B. Both Owner/Contractor are responsible for installing Carbon Monoxide Alarms prior to final inspection as per the aforementioned building code and maintaining such installation. Smoke Alarms will also be installed prior to final inspection as per the 2016 CRC. Smoke and Carbon Monoxide alarms are now installed in the following locations: �-- S,*yA-e_pe_cfor pp.w Qe,,AmzQ J= SA41al(e Z; it;4 /.yoa1 %._ /1 �I h�n AC1.osa9Via dP i AL %'Pi fa - Owner's name (print): J611 h 6? le, Owner's signature: Date: /` a Contractor's name ( int): CSLB License: Contractor's signature: Date: Project Address: % ylP % J%9Nd%ti st �'r/fY CG' - Permit #: !3/ Page 2 of 2 Revised 12.19.2016 . -; ", "- Butte County Department of Development Services PERMIT CENTER I` • • •7;County Center Drive, Oroville, CA 95965 ' n Main Phonc (530) 538-7601 Fax (530) 538-7785 IJ t ttvltwui,asnwcs _ w .'vwv.bunecountv.ncddd_q Re -Roofing -and -the.,20.08California,Res idential.Energy. C.ompliance� ; R-quireMdn%J6r4Cool?Roofs , i # _ _ .,(. �. . Important,information you needlo*now,BEFORE obtaining,a • ' • - reroof'pemiitl!. - , The .California Ene Commission CEC has ado fed new re uiiements;for-re-rooTin - ` C9Y l 1 P 4 9 Prpjecf�. ' Beginning January4 '2010,when more than 60%qof ikf-dxterior.surface of�thd:roofor;m"ore;,than 1,000=sq ft'.,of a -,,_, roof is replaced,{ hlchever Is lei's; the roofinggroduct'`must'ineet the`followingpresctrire requirements for Coot Roois: r ' Fot_ roof slopes "of greater'tha-n 2:12: w . 1. Roofing; products; with'a density of'less,than 5lbs/sq ft (i.e Asphalt shingles)"shall have a minimum 3 -year _„ n ._ aged solar reflectance of 0;20 and a minimum therTnahemittance oit T6 ;or a Solar.REflectance Iniiex (SRI) of 16: - ^ 2. Roofing pro•ducts.with a,density of, 6lbs/9q ft. m-fn6re (Le. Concrete clay tiles or slate)Jst all have a minimum * 3=year aged solar.reflectanee of 0.15 and a,minimum'thetmal emittance.ofi0.75,'or'a!Sllkj,6 10: , or, -- Altematives to the .Cool Roof,requirement�may'b,eone'oi'the following: 1.: Insulation with 43 thermal resistance of at Iea9fO':8W..fV.°F/Bt6 or at least % inch air -space is added_ to,the'roof deck: over an attic; or 2. If°existing ducts m the attic are; insulated and sealed according to CEG, Regulations §1!:1(010 ; or at, least R-30 ceiling insulation; or 3. Buildings with a - 4. If the building with a radiant barrier in the attic meeting the requirements of §151'(02 ; o ' 5. Buildings with no -ducts in the attic; of 4 , ,6. If in climate Zpnes.l0, 11,'13, and 14, R-3 or,great6eroof deck insulation above vented attic. 7. ' Roof -ateas covered by integrated photovoltaic panels and building integrated solar Itahels and existing roof areas that have a thermal mass oyer the roof membrane with a weight ofAat least 25` Ib/J2 are exempted for this . requirement. ' ]n A ,Certificate of Compliance .Energy Form "CF -1R -ALT_" must be completed and subaitted with the. permit application. The "CF -1R -ALT" form must be•sigrieO by the documentation Author and the Building Designer (Le. 1 Contractor or Home Owner). At Final Inspection an Installation Certificate Form CF-6R-ENV01^ must be completed by the installing contractor- ' andfsubmitted to the owner, and the building department. , .s.._�.uwit r... •.1•��: «:•a.ii....ue :.taw. .� � �_•i ..._. Roofing products that are used for c onViinnce with the energy standards are required to be tested and labeled by the Cool Roof Rung Council (CRRC). The roofing products manufacturer rnust have Its roofing product tested for solar reffectarm and thermal emittance, and be listed in the CRRVs Rated Product Director)/ (see hft:/Lw w—aaQIr* S.Om1 and be !abated according to CRRC procures. below Is an exarrlpte of an approved CRRC product label. 09A 'V CR Initial Weathered Solar Reflectance 0.00 Pending Thermal Emiitanee 0.00 Pending lbtW Product ID Nwnber l Cool ROOF LiWWW Salter ID Number _ _., RAIiNG QOUPr(RZ. • Classification Production Liao Cool RoofRattugCa%mWrd ,prods dfarafmdMcfaoadid=%and aq:Mtowpmopo— fardetwmtatsg aeas,om ABYpada�anse.lTteaataa! etTeotofrota:rafkc�oapactt6nmale anoe �=7ML M of pmahtot at�pala6ea that fltese eat�gs vaem is aaaozdanoa wi@t �o appttaatte Coo! RooiRattug C�proredmaa. Madred are the Cl =1 R,ALT and the CF -6R -EW -01 forms for your use. Or you can vWt the California Energy COMMIssfons webpage at: Www.erceray.caaav for more f dbvrn n. s a /a,,e fee -e>^ iAQ. M,Ap-6 o q� q'g-d 1943 kdd"on'ds4andmgr.01'(K:)IBUIWINCMEMTEFORMS1Forms2010/lnnragressJ000llootamouncemml 01-0 -IoNJS :4 Butte County Department of Development Services PERMIT CENTER _ 0, o 7 County Centcr Drive, Oroville, CA 95965 o etvuavu+r ss.rcrs Main Phonc (530) 538-7601 Fax (530) 538-7785 www.but1 ccountv.nct/ddt COOL REROOF INFORMATION:SHEET FORM: NO DPI -3 Project Address: / Y 1 % Ma f&VAk s -(., i% Cd,, Slope of.Roof # of Existing. Layers _� Existing Roofing Material�k%ir.� $�►�y/� 1`ad sh%�p� Check all that applies to NEW roof: , / Com oshion o Tite o Shake o Wood.shingle, P ,o Built up o - .Bitumen o Metal o Other - ._.. ❑ Tear off existing o Overlay o New Sheathing n ..;►. The California Energy Commission (CEC) has adopted new requirements for re -roofing projects. Beginning :Januar 1. 2010 _when more than 50% of -the exterior, surface of the -roof or more than0,000-s-1. (t of roof is replaced, whichever is less, the new, roofing area must meet the roofing product 'Cool Roor requirements, of §152.b)..Hi,,152(b),1Hii,`or 152(b)1HiiL ` For roof slopes of greater than, 2:12: Roofing products -with a'density of less than Slbsisq.ft-(i.e. Roofing produds,wilh a density,of 51bs1s41L or..mom. (i.e: Asphalt shingles) shall have a minimum 3 -year aged solar Concrete, day Tiles or slate shall.have a minium�it reflectance of 0.20 and a minimum thermal 6 Ittance of aged solar reflectance of 0.15 and a minimum. thermal` 0.75, or,a Solar Reflectance Index (SRI) of 16. O emillance of 0.75, or a. SRI of 10. or check altemate (alt) or check'altemate (alt) Note: Manufacturers specification for Cool Roof compliance when required shall be provided for Inspector. Packaging matenals`w/CRRC IaBbels�must be left on the job site to demonstrate compliance with the specification for the cool roof rating If applicable. ALTERNATE (ALT)Altematfves to §152(b)1HI and §152(b)HII, Stee"Icipe roof (pileh > 2:12) Alternatives to the Cool Roof requirement may be one of the following:_ Bulding with at least R40 ceding insulation If In climate,2one'l V. R-3 cr-greater roof, deck -insulation aft o (approximately„11' (or more):thldc if blown In) all o above vented attic.` EclstIng duds Insulated with R-6 and H.E.R.S. Building has no HVAC duds-ia the attic aft o dud tested to verify ducts are sealed all o (evaporative coring dud exenpl) aft o Building with a radiant barrier In stlicmeeting the requirements all o Insulation overroof deck or al least % inch air -space is : of §151(f)2; added to the roof deck over °an,attic Other Exceptlons • Roofing area covered by building Integrated; photovoltaic panels and solar thermal panels are exempt from lheibelow Cool Roof criteria. • Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft2 Is exempt from the bEllow Cool Roof criteria: • Buffe County areas within Climate Zone ! 1 per T-24, Part 6, 2008 California Energy Code: Bangor, Berry Geek Biggs, Centerville Powerhouse, Cherokee, Chico, Cohasset, Dayton, De Saba, Durham. East Biggs, Forest Ranch, Gridley, Honcut, Lake Oroville, Lake. Wyandotte, Las Pumas, Magalls, Nelson, Nord, Oroville, OroWle East, Palermo, Paradise, Pentz, Richardson Springs, Richvafe, south Oroville, Thermalito Thennalflo ARerba •Thermahlo F;Dmbav, Tiver Creek Powerhouse and Wyandotte. CLIMATE ZONE 16 (ONLY) Cool roof requirements apply ONLY when Roofing products with a density of 5lbsisq.0- or more (i.e. Concrete. day tiles or slate) shall have a minimum 3 -year aged solar reflectance of 0.15 and a minimum thermal emillance of 0.75, or,a SRI of 10: or check alternate (alt) as applicable. INSTRUCTIONS FOR COMMERCIAL PROJECTS ---- • Commercial roofs on decks with a slope of 2:12 or less must meet the 2008 Building Energy Efficiency Slandaris by being a certified Cod Roof. A caw of the slandasds slaved by the ayOlcarl must aaarparty (his dPDflcation • Overlays that exceed 100 pounds per square must be accompanied by calculations performed by a California licensed Civil or Structural Engineer. All overlays must be approved by the Building Official and other requirements listed within Appendix Chapter 15, Califomla Building Code. • A specification from the inofina manufacturer m M acm"VEN this acOlcalim The specification should list the fire class of the material, a description of the materials or layers that must be installed, the Cool Roof certification (If required because of the slope of the root), and installation requirements. • Packaging materials w1C nRC labels must be left on the job site to demonstrate compliance with the specification for the cool roof rating If applicable. - I agree that the Informa on is do a to and true. Applicants Signature: Date: /�— / CF -6'R -ENV -M- ROOFING INSTALLATION CERTIFICATE (Revlaed for fc0 ft ollly) CF B MW41 Envelope — Roofing 390 A94mm, EnfonlmmdAGMW.. PennaNmnm . "more Man one person Rola reaporrel�►tbrArsmBaflar dr1Ma Rams dJrl , soar pefsdtrr ansli propane and atgrr a oefe appli�la b Ma pm tun of conslnrobn fort *M Mayans mspwxb &&mW&ely, Me person with d d9fresponsW1yIbro a►s Wpmpafe and sip M cef bdO for MaenfQecomftcNon A9d trle ati<andara>s►MMM cram MOCkboxes Mqtft to hedwdwdto mm mandfaby measures have been met ATTIC ROOF INSULATION ANDIOR ATTIC RADIANT BARRIER tlterfak Brand Nems: Matedak Brand Name: Threes (orates): Themed Residarm (R.Vakw). O 6ile(a): bs ddon 6tateifed nmeb stanitani for boAattrtg Material. O §IWW: Mandatory Vapor bander Inswed M Climate Zone t8 Deecdoflon of Roofing Plodf Ab CRRCPhPdW Mmm&b= srud"ad l Rro&at Roof Roof Pdedua Hadar Sala Aged Solar Thermal ID Humber to Area Mw WeWjt Rcffa*o Rammer emftmoce 1. fie CRRC Pmdud m Numbwaart heabOWAnm Me dbW RodlfRaft C mmcfl's RaW Preach! Dftdory a mr►mcc0o9odrfa--------- -- — _.._._......__._. 2 The wnfgM fn lbs persqua+e t±;et ofMe roof pfvdu0 fre9rg lr> 3. t�CArbeue ffMeAgedRa�a�llsa dvanas usbrBMa er�a9orrbslbw, roonrote a. 4.)f Me egad r Amftme to not est fb go Cool RoofRaft Cbma$e laded Product Dlseddwy Men on Me 6tRfalfatfB cftvss vM0 from Me 0edwy and use Me equdbn (02vR7(pAtfBaf-0.4 b obtah a cmb&Wed aged valga. QC HECKAPPIJCAB, _gC MOW lF D®NPT FROM JNE ROOF LG-ERODflLL�A�(-ROOF REQUIRE YT o The mof area covered by buMM Inmgrated phobvo[m►o porters and Iqd ft Integrated sown Utamtal parmis are etaaetI - ttem Me above cool godcrftaft O Roos man cm the toot membrane Wth a weVd of at least 25 IbW IS almmpted from Bre Maw Cool Rod craerfa. Tb WlyL*W Recd gppbd CoetA' A Me waft,Raaf be sppded w M a Wftdn cky nW M akness of 20 raft across Me doe mot wdbw meet nW wm pwfbr nmw mgtr moo talhted In §118M end T&W 118-C Sstedd McWfibab l a 009MV O Abanitwm•PlgmBnted Amotak Root CoaMtg O Cemer"ased Root Coaft OOUM aCRRC4 LabaA Aaeolted to WAR YnoCRRC-1kWb avnftk ft coamMmm ,m vWcennot be umd andanodwrmaModIs MWAW band MoftmL DECLARATION STATEMMfT • I caRNy under penalty of porAOI • adder Ute laws Mftre Std of CaOxfda. Ute InAmwiflan p rmAded on fhie form Is bus and ow eon. • I aan eQPb under DMaton 3 of Ute f&m and Pmftdom Code to accept mspmtafh 2V for cormhuftn or an mMximd mp a of Ute person n3spormate for dst>fa dlwr (mapormbe person). • 1 cerflfy Utstthe Its feemrtes, rtmtmUP conVerwrb, or m damaed devloes Iden9fled an Udo a (fits Instagafth) am mte to all epp&$bb codes and mpddJm and lite btstdaiton Is consbie 1t vffh the pbm and aped apptOm d by fhb enforoenmmd agency. • I rwAv msd a copy of the CeMcefa of Car (CF -1R) form apprvre0 by Ute entoroemrtenl agetmry Met b*ma es Bre madilm matdrements for the tests Wftm I carW Uta! the mgmdtemmtard8 dole, ed an the CF -IR Mapply to the bar have been maL • I mail enamoe that a c=pWA elgned copy of dit bwfolte m Corditab shell be poew, or made avam*fe wfth the butldtag pemtt!(a) Issued for the beadhiS and casae avabble to tho oftco tent agency for aft eppdcabta hmpecOom l understaM that a etgrted copy of forts try t&dion cerwt ab Is mqufded to be Included with the documwdaftn the btMer provtdos to the buudbmg owner at occupertcy. Y6 k dGivct on'Us•IwtrUugi t1f'tK.tM1111 1)IhItL4VFP`it'f}° Ft};„rtSil orbs :!OtUnn P�c>�,rm4l fir laenUm+ CcMicoh, �,P if -ENJ t)1 - — (j1 tI(i 1Q 1V IS