12080129 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19972 PORTAL PL7 CON I'RACI'OR:FRANK FIALA ROOFING PERMIT SO: 12080129
INC
O\VNER'S NAMF: CHUI DAVID K TRUSTEE R E'1'AL 1238 QUARRY I N SIT C DA'Z'E ISSUED:08/132012
OWNER'S PHONE: 4087251753 PLEASANFON.CA 94566 PHONE NO:(925)484-0124
❑ LICENSED CC)NI'RACI'OR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
Liccnse Class Z--?Y Lie.# FAQ/7 70.7 r r r
msr� AtECH RESIDENTIAL COiCOMMERCIALComractor /f-•�j�.
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE BUILT-UP ROOFING AND INSTALL NEW I2"
(Commencing with Section 7000)of Division 3 of the Business S Professions COX
Code and that Inc license is in full force and effect. PLYWOOD;INSTALL IW"DENS DL'CK;REPLACE FLASHING;
AND INSTALL 540SQFT NEW CLASS A DURO-LAST ROOFING
I hereby affirm under penalty of perjury one of the following bwo declarations:
I have and will maintain a certi licate of consent to self insure for Worker's
Compensation,as 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 for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq. FI Floor Arca: Valuation:$5920
A I'1'LIG\Nl'CIiR'fII�IC.VI'ION
I certify that I have read this application and state that the above information is ANN Number:36945006.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and state lues relating
to building construction,and hereby authorize representatives of this city to enter
upon the abovementioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the Cityo'Cupcnino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence ol'Ihe
graving of this.permit. Additionally.the applicant understandsand will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source re ulmiaispe the Cupertino Municipal Code,Seen.on 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signalurc Date �z Issued by">5;1� P"'
❑ OW'NEFt-IIIIILDER DECLARATION
hereby allinit that I not cvrngn front the Contractor's License Law formic of RF-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an in vection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(See.7044, inspection.
Business S Professions Code) /
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: Om,/�� / 2-
construct
construct the project(Sec.7044,Business S Professions Code).
1 hereby:dfirm under penally of perjury one of the Ibllnwing three AL1,ROOF COVERINGS TO BE CLASS"A"OR BET"ITHE
declarations:
I have and will maintain a Certificate of Consem to selfinsure for Worker's
DISCLOSURE'Compensation,as provided for by Section 3700 of the labor Code,for the II,\'/.,\RDOUS SBI,\'1'ISI21.\IS
pedornance of the work 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 Health S Safety Coda Sections 25505,25533.and 25534. 1 will maintain
Section 3700 of the Labor Code,for theerformance ofthc work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Ilealth S
F Safety Code.Section 25532(x)should I store or handle hazardous material.
permit is issued. AdditionaII3,should I use equipment or devices which emit hazardous air
I certify that in the perfor Unice ofthe work for which this permit is issued,I shall contaminants as defined by the Baa Area Air Quality Management District 1 will
not ennpby any person in any rummer so as to become subject to the Worker's maintain arum pliant a with the Cupertino Municipal Code.Chapter 9.12 and the
Compensation laws of California. 11'.after making this cenificate of exemption,I Ilralth S Safety de.S 25505.'_5533.and 25534.
become subject to the Worker's Compensation provisions of the Labor Code.I must -a
forthwith comply with such provisions or this permit shall be deemed revoked. 0%%ner or a ized a u:
Date ✓ L
APPLICANI'CERTI FICATION CONSTRIICI'ION LENDING AGENCY
I certify that I have read this application mid state that the above information is
correct.I agree to comply with all city ad county ordinances and 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 perinit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(IVC)agree to save Lender's Name
indenenify tend keep harmless the Cily ofCupenino 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 comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT"S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 19972 Partal Plaza (Bldg M) DATE: 08/10/2012 REVIEWED BY: Sean
\ APN: BP#: 'VALUATION: $5,920
*PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof
Multi-Family is PENTA IATION
USE: y Dwelling >3 Stories O Yes (E) No PERMITTYPE: 1R2R00
WORKRemove built-up-roofing and install new 1/2" CDX Plywood; install 1/4" Dens Deck; replace flashin
SCOPE and install new Class A Duro-Last roofing system (see ESR-1660).
FEE ID ROOFAREA
(S.f.)
1REROOFMRES 540
Afech. Plan Check Plumb.Plan Check Elee. Plan Check
Mech. Permit Fee: Plumb. Permit Fee: I F-lec.Permit Fee:
Other Afcch. Insp. Other Plumb Insp, Other Elce.lay.
A•lech.Insp. Few: Plumb. hasp.Fee: rice. Imp.Fee:
NOTE: This cvtinuue does not ineludejees due to other Departments(i.e. Planning, Public Works, Fire.Sanitary Sever District.Schaal
District.etc.). These feev are based on the preffininari in ornuaion available and are on1v an ectinmte. Contact dee De t or adtht'I in n.
FEE ITEMS (Fee l?"ohi ion /1-053 EIC 711/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
SuppL PC Fee
Phunb.11lech./E•lec
Permit Fee: $90.00
SuppL Insp Fee
Plumb./dlech./Elec
PlumhJhlech./F•lec Permit Fee:
Conso•tcdon Tax:
Administrative Fee:
Work Without Permit? O Yes (F) No $0.00
Advanced Planting Fccs:
Travel Doctnnentation Fees:
Strome Motion Pee: IeSF.ISMICe $0.59 Select an Administrative Item
131c1e Sids Commission Pee: IBCBSC $1.00
SUBTOTALS: $91.59 $0.00 TOTAL FEE: $91.59
Revised: 07/01/2012
I
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 _
GUPERT IN'.O (408)777-3228• FAX(408)777-3333•buildino(okupertino.oro
PRO er-r DD E$ 1 .. ,.� T //Ir A�PN'N�7 1 _Q_ Lf
> ' OQ r^
O 'iR NAME C-(1-(�,I p I P 7J~I /SIIILLLJJJ�1. E-MAIL
sTREF.TA RISS CI ,ST F.ZIV /lj �( ti FAX
CONTA A.\u t-tq_ DVre.iONE _ -t IL /(� O :n
STRE[:1'ADDRES � n C .SiATG,ZIP FAX _��r�
0 OWNER 0 OWNER-Butum t OWNERAGENT (— CONTRACTOR XONTRAC DRAGENT D ARCHITECT D ENGINEER D DEVELOPER D TENANT
CONTRACTOR NAI �^ 1r `Gl LICENSR NUMBER LICENSETYPP 35 BUS,LIC.aD
COMVNAME
rrCLnN ��0.�c` �Oo C SD 0 PSS `484 a75a
l DR 5 YY ft
Y,STATE,ZIPfte lec[_&nr\�W �A
ARCHTECT/ENGINEER NAME LICENSE NUMBER `r BUS.�LIC.0
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF 0 SFD or Duplex IVIBIII-Family ROOFAREA: VAGI UATION;
STRUCTURE: 0 Commercial Q �
EXISTINGROOFTYPE; `5BUILTUPROOF 'Cl ASPHALT SHINGLES ONVOODSHAKES DWOODSHINGLES O OTHER(SPECIFY)
REMOVEAREPLACE YES IFNO, PLYWOOD .di F. 0 PLYWD 0 OSB PITCH: ROOF
NO M LAYERS' THICKNESS: 5M.,SB" TYPE: CDX :12LASS: - t1
HI
PROPOSED ROOF TYPE: CI,BU1LT-UPROOF 11 ASPHALT SHINGLES ❑%%'ODD SHAKES 0WOOD SHINGLES 1AOTHERrO -F-S.REPT Tq
SCRIPTION OP WORK: I e
e Ty\0"(2 vlc I e Z T— C Ija�l, �el � (2ry �. D l wcsocl e� [ (L �4 v�
��LJooCI. .LutiS�+gl� I/`Ftl VQ-Y�S `J�C.�.�YetL.k-yw� S [-QG CLS 1\2�ua TLS
erMrn�e- ` R-�--I(J�c�eAr '20�� ��eLi�l�YlH tLU4S��l f�l.w r�S� �1Q- .
SO m; C.-+4iewww 14sCiC.
By my signature below.I certify,to each of the fol owing: I am th• roperty owner or authorized¢gen[to act on the property owlier's behalf. I have rend this
application and the information I have vided is Tract. I hav re d the r-/-,jeription of Work and verify it is accurate. I agree to comply with all applicable local
ordinantts and state lows relating t uil ' c etio�r. 1 a t or's re Jy'fi} aliv f('u ino to en er the above-iden Tied property for inspection purposes.
S ignature ofApplicanl/Agent: �(/ Date:
SUPPLEMEINFORMATION REQUIRED
with,a
Ifome Owner's Association,provide letter Ise�ni�LsA1�Is RHhckTi e.*`?.n s �')F'? '1" '%st.T( RGlfrlj'c'Siln"ry"'pJT'
of approval from HOA. "f'S.�L
� Ot FR`TIIFCp
__—(//__Pj'ro �tpaClL�x.71'fd°irsp�n7�A-'4'�T�•;"v'Rr,Di.' iFa'J=U
Ovide Plannin approval to verify If there an 'restrictions.vEhUUI`LN"'riG'aAr3�' AKa't'NSu,ykrR��F,zf>I'hEtaJw"PRLw
vide copy of Manufacturer's Installation Specifications.
Poidi ned coPY of Cu crtinos Tcar-0((folicy.r
S
,
t
ReroofApp_2011.doc revised 03/16/11
f
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 •CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333 • buildingrgDci oertino.org
PROIECTA00RESS P( i n I APN# j�
O 'NER NAVE r %n'/✓1 Pn l n r //S E.PINI.
E A DRES � Tl'. ATE.ZIP- rn/ n r--y�/ FAX
/ rV� 7J V
IU
R 17 LICENSE Nl S; BER UCESE TYPE BUS,LIC
N K-- t A-LA l(J L. F`r/�it✓ Q • el pE7 LJ ' -� 2 7S' 2-.
S`JIT'ADDRF / - Crr}',y-1';STE ZIP / /Lq Gl/_.OIZ7
(,[j/7 1 UNDERSTAND AND AGREE TO THE FOLLOWING: 7 a7
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 clay 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 nmst 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 Final 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-down 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 approval 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 nlininmum Of'14" 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.
8. 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. 1 understand and agree to comply with the re-roof policy stated above. I also understand that
smoke detectors and carbon oxid detect s ,re re u'rcd to be installed in accordance with Sections 8314 and 8315 of
the 2010 California Resid ua
Signature of Applicant/Agen . Date: B
ReroofPolicy_2011.doc revised 02/16/11