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11080153 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19942 PORTAL PLZ CONTRACTOR:FRANK FIALA PERMIT NO: 11080153 ROOFING INC OWNER'S NANIE: THOMAS TSO 1228 QUARRY LN STE C DATE ISSUED:08/23/2011 NE:R's PHONE: 4088639991 PLEASANTON, CA 94566 PHONE NO:(925)484-0124 ❑ LICENSED CONTRACTOR'S DECLARATION �`/ BUILDING PERMIT INFO: BLDG F- ELECT f— PLUMB f— License Class --3 Lic.# `j f— I-- F- ��s � S,7 // MECH RESIDENTIAL COMMERCIAL Contractor ( 1I1�1a�yu—%'�_Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG N-RE-ROOF 6 SQUARES-REMOVE OLD B.U.R. (commencing with Section 7000)of Division 3 of the Business&Professions INSTALL 1/4"DENS DECK.INSTALL NEW CLASS A DURO LAST ROOFING SYSTEM,INSTALL NEW 1/2"C.DX.PLYWOOD Code and that my license is in full force and effect. 1 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,as provided for by Section 3700 of the Labor Code,for the performance ofthe work for which this permit is issued. Sq.Ft Floor Area: Valuation:$6500 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 ofthe Labor Code,for the performance of the work for which this permit is issued APN Number:36945009.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 80 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter Upon the above mentioned property for inspection purposes. (We)agree to save 180 DA F OM LAST CALLED INSPE TI indemnity and keep harmless the City of Cupertino against liabilities,judgments, costs.and expenses which may accrue against said City in consequence ofthe /� gu rtnn2 ul this permit Additionally,the applicant understands and will comply Issued by: Date: 6 with all non-point source re ulations per the Cupertino Municipal Code,Section 9.18. /� RE-ROOFS: Signature Date ! All roots shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspe tion,I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION Signature of Applicant: Date: l/ hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner ofthe property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) L as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE Construct the project(Sec.7044.Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby, affirm under penalty of perjury one ofthe following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: health&Safety Code,Section 25532(a)should 1 store or handle hazardous I have and w ill maintain a Certificate of Consent to self insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance ofthe work for which this permit is issued. will maintain compliance with the Cupertino: unicipal Code,Chapter 9.12 and I have and will maintain Workers Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,2 3,a 25534. Section 3700 ofthe Labor Code,for the performance of the work for which this - Z� permit is issued, Owner or authorized agent: Date: 6 I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I ccrtiiy 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 to budding construction.and hereby authorize representatives of this city to enter upon the above mentioned property,for inspection purposes.(We)agree to save �mnifN and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION s,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. anting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9 I8 signature _____Date REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 GUPERTINC7 (408)777-3228• FAX (408)777-3333 • building cDcupertino.org rC1 �,l lO $ O/53 0 PR)JI CT ADDRESS I 1 1 L4 7APN 41 O\1 NF'.R AME o � ('� PH _E E-MAIL �s o' cv I STREET ADD`4C�q\ Cl , STAT eZIj d G� CONTACT NAME CS— PHONE E/-MAIL STIcEFT ADDRESS CITY,STATE,.ZIP FAX 1:1 JN'VER C1 OWNER-BUILDER OWNER AGENT 'CONTRACTOR 1:1 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DE LO�011N.Nl C0^1TKACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC N PlOda I eIV57 ✓ 1 �l �(J/' 'y P Y E-MAIL FAX// "rt FlaL" R (��tmci (17oo �/�J` ST. 'T Es uua�� dffiffin(4 P g- a 1--ant y L, ARCHITECT/ENGINEER NAME LICENSENUMBER BUS.LIC.P CO AP ANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE US! OF ❑ SFD or Duplex Multi-Family ROOF AREA: VA�,L�jUATION(0, STKUC'TURE: ElCommercial 'n'" 5 L , EXISTING ROOF TYPE: 15RUILT•UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) RENIOVE/REPLACE ` YES IF NO, PLYWOOD *w, 1:1PLYWD ❑ OSB PITCH: 1, ROOF 13 NO #LAYERS: THICKNESS: 115/8" TYPE: CDX y :1.2 CLASS: A Iwo L -d ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES OTHER 1. 0,DE CRIPTIONOF WORK: L.YYIa Q. - L «t�� p rv�v�l S X1,1 ' ILl PA �)Q_",_o CACL��s Lwo_ By I n y sign re below,I certify to each of the following: I am the property own or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have rea he Des iption of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I autho re a Ives of Cupertino to enter the above-/e ifie property for inspection purposes. Signature of Applicant/Agent: i Date: SUPPLEMENTAL INFORMATION REQUIRED '__ If building is associated with a Home Owner's Association,provide letter � .� • . r . .y4 :� ty�,u���;,t� -,z�ot�lrzN,c,slr,b��,_�,��,.4, ,; of approval from HOA. � _ I rovide Planning approval to verify if there any restrictions. ' '•S '�;� �� SPY."INNING PLAN RE��'I`EW*, , r _ Provide copy of Manufacturer's Installation Specifications. �k�,s 'I u� is ✓' ?s 1`°,��I .v^�i"�Y'� �I _ Provide signed copy of Cupertino's Tear-Off Policy. �. , •.� ��pi{R��'4j��i�'� 3 ��si�.r���r���''tF{.Id ii'+9•d�+ . .. � .. . ...•. � 'R�'-0in�.�fi�........�.r._.;. ,..i, :'I;C..,at it$n.Y�a'k�6�`�+...xri ReroofApp_201 1.doc revised 03/16/11 REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 C U P E RT 1 N O (408)777-3228- FAX (408)777-3333 PROJECT ADDRESS y z �t, L P APN# L V'�� W OWNS NAME a4i , Ck A// PHONE mEmir- 6 3 7 / / E-MAIL STREET ADDRESS �I 0� ` / GY, STATE,ZIP h /a Q �r--0 FAX CONTRACTOR NAME C �% /�� LICENSE NUMBER 0��©..� LICENSE TYPE BUS.LIC.# 3 q y g rw�/ L CO NY NAME E-MAIL Y CITY,STRETADD S SAZIP 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 - 3:30pm (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 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 minimum of 1/4"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 comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide deteciredAp be installed in accordance with Sections R314 and R315 of the 2010 California Residential Code. Signature of Applicant/Agent: Date: z ReroofPolicy_201 1.doc revised 02/16/11