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12080127 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19970 PORTAL PLZ CONTRACI'OR:FRANK FIALA ROOFING PERMIT NO: 12080127 INC OWNER'SNAM E: NAKAMURA DIANE K 1228 QUARRY LN STE C DA'Z'E ISSIJED:08/132012 O\v'N'ER'SPBONE: 4087364366 PLEASANTON.CA 94566 P1 IONT.NO:(925)4MA 1224 ❑ LICENSED COYTRAC'FORR''S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class 4f- y9 uc.N F71F® 707 r r� F- ��.. . - /7,1/e- � A /;L \IECII RESIDENTRESIDENTIALCOMMERCIALRCIAL Contractor � /' �_ 0�9 Dale g J-7_ I 1 hereby affirm that Into licensed wider the provisions of Chapter 9 JOB DESCRIPTION: REMOVE BUILT-UP ROOFING AND INS'T'ALL NEW 12" (commencing,,iih Section 7000)or Division 3 of the Business S Professions CDS Codc:md that my license is in full force and effect. PLYWOOD;INSTALL 1/4"DLNS DECK;REPLACE PLASIJING;AND INSTALL 540SQFT NEW CLASS A DURO-LAST 1 hereby affirm under penalty of perjury our of the following rvo declarations: I have and will maintain a certificate ofconsem 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 pedortnance of die work for which this permit is issued. Sq. Ft Floor Area: Valuation:$5920 A I'I'LIG\NI'Ch:K'I'I F'IC.\'PION I certify that I have read this application and slate that the above information is ,%NN Number:36945007.00 Occupancy Type: correct.I agree to comply with all city and county ordinances mrd state laws relating to building construction,mrd hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City ol'Cupeninoagainst liabilitics,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,anti expenses which may accrue against said City in consequence of the granting of Ibis pemtit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source eguI tDate Issued by Date`-1'' sper the Cupertino Municipal Code.Section 180 DAYS FROM LAST CALLED INSPECTION. nature g 9.18. Si _ 4�-j—�Z ^; �7��_ �L F-1 ONVNER-RUILDER DECLARATION I hereby affirm that I am esempt from the Contractor's License Law for une of Rh:ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material bcimg installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an in (iec w , agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. BusinessSProfessions Code) 8 PP ry �3—�Z I,as owner of the property,am exclusively contract ing with licensed couture tors to Si nature of A li©m: /�" Date: J construct the project(Sec.7044,Business S Professions Code). I hereby affirm under penalty or perjury one of the following three ALL ROOF COVERINGS TO BE.CLASS"A"OR Ill'Y'ER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the performance of Tire work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I,have and will nmintain Worker's Compensation Insurance,as provided for by California Ikalth S Safety Code Sections 25505.25533.and 25534. 1 will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the dealth S Safety Code,Section_553_(x)should [store or handle hazardous material. permit is issued Additionally,should I use equipment or devices which emit hazardous air I cenlfy that in the pert armmKl'of die work Im-whichthis permit Is Issued,I Shall contaminants as defined by the Bay Area Air Quality Management District 1%%ill not employ any person in any manner so as'to become subject to the Worker's maintain compliance s,ith the Cupertino Municipal Code.Chapter 9.12 and the Compensation laws of California. If,atter making this certificate of exemption.I 11ydth S Safety Cu e.Sectio s 25505,25533.and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this pernfi shall be deemed revoked Ovyner or auth r d ug e (7 Date: —1L AI'I'LIC.\N'I'ta?K'1'1 PTC.\'TION CONSTRUCI'ION LEN DING.%GENCY I certify that I.have read this application and state that the above information is correct.I agree to comply with all city and 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,mrd 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 indemnity and keep harmless the City of Cupertino against l abilities,judgnments, casts,and expenses which may accrue against said City in consequence of the Lender's Address granting of this pernmit.Additionally,the applicant understands and will comply With all 11011-poiiu source regulations per the Cupertino Municipal Code,Section ,\KCIII'I'ECI"S DECLARATION9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 1.2- 4 ADDRESS: 19970 Partal Plaza (Bldg M) DATE: 0 811 012 0 1 2 REVIE\\'ED 6\': Sean APN; RP#: 'VALUATION: $5,920 *PERMIT"P\'PE: Minor Building Permit PLAN CIIFCK"1'1'PE: Re-roof PRIMARY BUildino is PEN PAMATION 1 R2ROOF USE: Multi-Family Dwelling >3 Stories O Yes (F) No PERMIT TYPE: i \\'ORKRemove built-up-roofing and install new 1/2" CDX PI)Mood; install 1/4" Dens Deck; replace flashing; SCOPE and install new Class A Duro-Last roofing system (see ESR-1660). FEE ID ROOFAREA (s.f.) 1REROOFMRES 540 ,Neth. Plan Check LPhonb_Plan Check Flee. Plat Check dlech. Permit Fee: Plumb.Permit Fec: Elec.Permit Fee: Dd�m•,tlech.Ince. 011ier Plumb Insp. Odter Eler.Insp. Ple.ch.hap. Fee: Plumb. bt.vp. Fee: Flee Insp. Fee: NOTE: This estinuae does not include fees due to otter Departments(i.e. Planning, Public Works, Fire,Sanitary Server District,School District, etc.). These feev are baser/on the prelintinan information available and are onh,nn estimate. Contact the Dept for addh'I info. FEE ITEMS (Fce Resolution /1-053 EI1: 711/11) FEE QTl'/FEE MISC ITEMS Plein Check Fee: Suppl. PC Fee Pl umb./d-tech./El ec. Permit Fee: $90.00 Suppl. Insp Fee Plumb.lAlech./Flee Plumb.lMee.h.lElec Permit Fee: Cons/r•ttction Tar: Administrative Fee: Work Without Permit? O Yes Q No $0.00 Advanced Planting Fees: Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $0.59 Select an Administrative Item Blde Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $91.591 $0.001 TOTAL FEE: 1 $91.59 Revised: 07/01/2012 Iry REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 C'.UP..ERTINO (408)777-3228• FAX (408)777-3333•buildine(a),cupertino.org , PR IECr ADDRESS n J_ � P APNa �� 00 OV�NI:R NAME rJ I(� " d PIi 69-- -7�! N, E-MAIL �l�J� STJ2F� T0, 'aN K-/s C Y,STATE,ZIP .rhs`/ 1e FAX ` ,IIiL(.~IVV h- I V l ylV[6 Tl —U Z /✓ E+'] STREEI'ADDRE$$ /] CI' Y STA'Tf.ZIP FAX r ❑OWNER ❑ OWN'ER-BINDER ❑ ORXERAGENT CONTRACTOR MCONTRACTORAGE.NT ❑ ARCHTECr ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME 1r \Gl LICENSENUMBE LICENSETYP .30 BUS. IC.b COhf NY NAM1IE L.-l. p �-l. B t `-� P :�.5 VIr 1 Y.STATE.ZIP ARCHITECT/ENGINECRNAME LICENSENUMBER J BUS.LICq COMPANY NAME E-MAIL FAX STREEr ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex '[ Muhi-Family ROOFAIRRE/.A: ,(\� VAL ATION: STRUCTURE: ❑ Commercial I 0 v 'fS 9w EXISTING ROOF TYPE: .BUILT-UPROOF ❑ASPHALT SHINGLES ❑WOODSHAKFS ❑WOODSWNGLES ❑OTHER(SPECIFY) REMOVE/REPLACE YES IFNO. PLYWOODK" ❑ PLYWD ❑ OSB PITCH: ROOF NO a LAYERS- THICKNES ❑LS" TYPE: CD% •(Z LASS Utz f PROPOSEDROOFTYPE: ❑_BUILT-UPROOF ❑ASPHALT SfENGLES ❑\FOOD SHAKES ❑WOODSIGNGLES OTHER-0- -ES REP` Ta SCRIPTION OF WORK: c ernov¢ old fm14lk NeLA� 2" C. DXplslocy(ODye%( l �tc� inh L����d. v�s�wl► '/4i1 dens �2e k. I�recL trout SeeG QS V�2e,Qec� �" ' ,�z � tom' 'R-o�f �I�fln�n �u4slv��l ►.�ec� 1a� L� — SOm C,tiie-4, w (0.S11C- By my signature below,I ceriify to each of the fol awing: I am the property owner or authorized agent to act on the property Owrier's behalf. I have read this application and the information 1 hav Ovide is correct. I h reap the Description of Work and verify it is accurruc. I agree to comply with all applicable local ordinances and state laws relating bui a Inaction. ut ori ntatives oI'Cupenino to enter the above-id nufP d ro ny for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMEN INFOItNIATION REQUIRED �,s1r'a-`�rik',a.� `f I`r',ra gxNlc ust 9br �L�i2 +Lfv "-'g'zs'+u' t rs _ If building is associated with a Nome Owner's Association,provide lettera�.�, lyc 5iy�{'�t� of approval from HOA. S` � c Zssit'f ❑ w Sw?t 'e3 " S y r � ,_ 2�9UILU1\f,rill ARE\IFNT -'' Pf14 ovide Planning approval to Verify i(there any restrictions. __. (o V/ R\I Rh55y ' ,.Z�s ��i e© PL \�ItiCIPLA�RE\IETN �.' vide copy of Manufacturer's Installation Specifications. ��Y,��r�•-++� s� i.- Provide signed copy of Cupenino's'1'ear-0(f Policy. �,y,v yg 1+�At* 2rs�- ' �oi�il y�'"� 1FtcN,- RerobfApp_2011.doc revised 03/16/11 r' REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)77r7--3228 • FAX(408)777-3333 • buildina(&cupertino.oro PR JE L PLAZA BId � APNq Ot 'ER I:A\IE n 1/ fAA" r�- F O'CE 73& -'549 STREL \ 'SS /) ,vVvYl-A Z 4 CI ST OTiE ZIP !P FAX NO 1,A1,A9SZ� /rf CON1RACr R i\1F,�. LICENSE NVl16ER LICE�.'SE TYPE BUS-LIC.N r L' — ZZ Cfp41 :1N1'N{NIE C\ ,y�a� FIX N K-- I A-C-A l IJ L, /Lj O •/ C� qKS - w 2— SS L2_ srREer AnpRP , / _ Qv) srACCII .SZ/10 yo7.S ���Z7 1 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 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pn1 (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 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-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 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 nlinini un of%" 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$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 comp wit the re-roof policy stated above. I also understand that smoke detectors and carbon mono detectors are fir tobe Installed in accordance with Sections R314 and R315 of the 2010 California Residential od / Signature of Applicant/Agent: Date. RerooJPolicy_2011.doc revised 02/16/11