12080126 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19978 PORTAL PLZ CON FRAC'FOR:FRANK FIALA ROOFING PERMITNO: 12080126
INC
OP'NER'SNA\IE: CHRISTOPHER AN'I'llONYJ AND BETT 1228 QUARRYLN SFE C DA'Z'E ISSUED:08/132012
O\VNER'S PRONE: 4159649781 PLEASANT'ON,CA 94566 P1 IONE NO:19 2 51 484-0124
❑ LICENSED C(>NI'ItA(-.1'OR'S DECLARATION BUILDING PERMIT INFO: RLDC (- ELECT r PLUMB r
License Class Lie.H
111ECF1 (- RESIDENTIAL r1 CODIp1ERCLV. 1-1
Contractor Date
I hereby affirm Thal I am licensed under the provisions of Chapter 9 •JOB DESCRIPTION: REMOVE BUILT-UP ROOFING AND INSTALL 5 SOS NE-%V
(con]meneing with Section 7000)of Division 3 of rhe Business S Professions 12"
Code and that nn'license is in full force and effect.
COX PLYWOOD;INSTALL 1/4"DENS DECK;REPLACE
FLASKING;INSTALL NEW CLASS A DURO-LAST ROOFING
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,a;provided for by Section 3700 of the labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided f'or by
Section 3700 of the Labor Code,for the perfommance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$7381
APPLICANTCERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36945003.00 OccurymcyType:
correct. I agree to comply with all city and county ordinances mid stile laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save
inderianiN and keep harmless the City ol'Cupenino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue:against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date Issued by: Date:
❑ OWNER-BIIILDER DECLARATION
1 hereby affirm that I am exempt front the Contractor's License Lawfor(tile of RE-ROOFS:
the following ton reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,many employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,mid the structure is not intended or offered for sale(Sec.7044, inspection.
Business d Professions Code)
I,as owner of the property,am cxdusivdy contracting with licensed commctors to Signature of ApplicanC Date:
construct the project(Sce.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three AL1.ROOF COVERINGS TO RE CLASS"A"Olt BE IYER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's IIA"7.ARDOUS JIATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the stork for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Ilealth S Safety Code,Sections 25505.25533,and,5534. 1 will maintain
Section 3700 o(the Labor Code,for doe performance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.1_and the Ilealth S
p Safely Code.Section 25532(x)should 1 store or handle hazardous material.
permit is issued Additionally,should I use equipment or devices which emit hazardous air
I cerify that in the performance of the work(orwhich this permit is issued,I shall contaminants as defined by the Bay Area Air Qualil) Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with.the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws ofCaliforia. If.atter making this cenificate of exemption,I Health J Safety Code.Sections 25505.25533.and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I mast
forthwith comply with such provisions or this permit shall be deemed revoked Owner or authorized agent:
Date:
APPLICANT CFRTIFICATION CONST RUC11ON LENDING AGENCY
Icertily that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances mid state laws relating I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,;and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemmnity and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will conhply
with all non-point source regulatims per the Cupertino Municipal Code,Section ARCII ITIiCI'•S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
OU2 P.ER 0 (408)777-3228 • FAX (408)777-3333•buildinq(@cupertino.org
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CONTRACTOR NAME LICENSL. St B" LICENSETY I HUS I C o �
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ARCHITECT/ENGMEERNAME LICF;NSE NUMBER I BUS.LIC.d
COMPANY NAME
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STREET ADDRM- CITY,STATE,ZIP
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USH OF ❑ SFU or Duplex 4 Muhl-l:unily ROOT nREn: vnLun7utN:
STRUT rum: ❑ Commercial 15 S .F�-• 4 381 —
ENINI ING ROOF TYPE: 'q•DUILTUPROOF ❑ASPHALTSfUNGLES ❑WOGDSHAKFS ❑WOODSHINGLES 00'1'UHRtSPECIFY)
REMOVE ntEPLnCH ins IP NO. PLYWOOD 'qL'A" ❑ PLYWD ❑ OSI1 PITCH: RUOP
No u"YERS TfD AN SSS ❑ 5l9" TYPF St COXA
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PROPOSED RDOFTYPE: ❑DUILT-UP ROOF ❑ASPHALT SIDNGLES ❑WOOD SHARES 11 WOOD SIDNGLES 011IHR "--FLti ItRI'UI TU
SCkIPTION OF WORK:
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By my signature below.I certify to each of the fallowing:: I \the property ovner or authorized agent to act on the properly o\rncr's behalf. I have read this
application and the information I have provided is correct. I 'a'e r. the Descriptiunof Work and verily it is accm:ne. I agree to comply With BII applicable local
oromances and state law's relating d' ilaVucliol Ia d ep flab's of Cupertino to enter is nbowe.i•Irntin••
nspecuun pwpo'es'
Signal of ApplicanVAgenl:
Date:
SUPPLBME Al,INFOKNIA"1'ION RI QUIREIDiy 1.FTp ,''•'.w'eY a< wren ?'A .3.ca c'�n a ti .
F�OhP ICP U)I
_- If building is associated with a Home Owner's Association,provide letter 4$>` + Cw`.cR t 1 y,w<r.,,!`A a yam' - r•� - r""1 °yy ngl
e IIl01Jl I\U')PIYI r ctrl G
Of approval from FIOA. > y'A 4caJ,rya^ ?ti
0\FR IUF'EpDYIPItr} ? (Ll��tnUll Vl\O11 \\IO\HNti-jrr�,
Provide Planning approval to verify i(Ihere any restrictions, � rflM� w >n�,u �•-Afiks r c r s
s�yfj, ct rI '�'e,d ulw} It�{'ii l)\\AI\CIPL\)It \'IE\V�111 .anti
_,A'rovidc copy of Manufacturer's installation Specifications.
❑�.,,s�r\\u\ROFn � trs�ryy t �p,''Y'tt l�.uLPT u' 7y'+�� >'<
V _ 1'rovide signed copy of Cuperlino's'I'ear Off Policy.
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2 REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
C U P E RT I N O 10300 TORRE AVENUE •CUPERTI NO, CA 95014-3255
(408)7777--3228• FAX(408)777-3333• buildina(aDcuoertino.ora
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CONTRACr R A?IF�: LICENSE NV\IBFR LICEIJSLTPE BUS.LIC
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777-
3228 from 7:30 - 3:30pn1 (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection.
For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that
phase of the work is completed. The building inspector will be available within one hour. Progress
and Filial Inspections will be given a two hour window.
3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either
completely knocked-clown or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the
building inspector. Any roofing which is applied without first obtaining an approved inspection will
require the removal of all new material down to the sheathing so a proper inspection can be performed.
6. Progress Inspection is required when approximately 50% of roof covering is installed.
7. A Final Inspection and anproval shall be obtained from the building inspector when the re-roofing is
completed. To receive a final sign-off, the following items will be verified:
a. Flat roofs shall have a minimum of 114" per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manufactured products used shall be
available on-site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed.
S. NOTE: If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be
charged a re-inspection fee of S 126.00. The re-inspection fee shall be paid before another inspection
can be scheduled.
By my signing,below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to c ply all the re-roof policy stated above. I also understand that
smoke detectors and carbon n xidc d ctors ar c uir d e installed in accordance with Sections 8314 and R315 of
the 2010 California Resid tial g/L
Signature of Applicant/Age c Date:
ReroofPolicy_2011.doc revised 02/16111
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 19978 Portal Plaza (Bldg L) DATE: 08/13/2012 REVIENVED BY: Sean
APN: BP#: 12080126 VALUATION: $7,381
*PERDU"f TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
PRIMARY Buildino is PENTADIATION
USE: Multi-Family Dwelling >3 Stories 0 Yes 0 No PERDIIT TYPE: 1 R2ROOF
WORK Remove built up roofing and install new 1/2" CDX plywood; install 1/4" Dens Deck; replace flashing and
SCOPE install new Class A Duro-Last roofing system (see ESR-1660).
FEE ID ROOFAREA
(s.f.)
1REROOFMRES 533
Meeh.Plan Check Numb.Plan Check Cleo.Plan Check
dfech. Permit Fee: Phanh.Permit Fee: Elec.Permit Fee:
Other Mech.lasp. Other Plumb hu'p. Other Elec.Insp.
ilfu:h.Insp.Fee: Plumb.btsp.Fee: Fier. Insp.Fee:
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Server District,School
District,etc.). Thesefees are based on the prelitninarl•information asmilable and are onll•an estimate. Contact the Det for addn 7 info.
FEE ITEDIS(Fee Resolution 11-053 Elf. 711/11) FEE QTY/FEE DIISC ITEDIS
Plan Cheek Fee:
.Supp/. PC Fee
Pluwh...'Heeh.iElee
Permit Fee: $90.00
Supp/. Insp Fee
Plumh.lillech.iElec
Phimb.1,11ec•h.;Elee Permil Fee:
Consrruction Tax:
.d,lministrative Fee:
Work Without Pemtit? 0 Yes (j) No $0.00
Aclvanc•ed Planning Fees:
Trimel Documentation Fees:
Strone Motion Fee: IBSEISMICR $0.74 Select an Administrative Item
tt
ommission Fee: IBCBSC $1.00
SUBTOTALS: $91.74 $0.001TOTAL FEE: $91.74
Revised: 07/01/2012