10060194 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19803 PORTAL PLZ CONTRACTOR:FRANK FIALA ROOFING PERMIT NO: 10060194
INC
NER'S NAME: HAMIEL&MARYAM ZIARI 12:,8 QUARRY LN STE C DATE ISSUED:06/30/2010
OWNER'S PHONE: 4087770111 PLEASANTON,CA 94566 PHONE NO:(925)484-0124
❑ LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG� ELECT � PLUMB �
License Class Lic.# P , Q�
�j MECH RESIDENTIAL COMMERCIAL
Contractor F/a.• 14 ��It OLDdDate
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: BLDG G-RMV OLD B.U.R.INSTALL 1/4"DENS DECK.
(commencing with Section 7000)of Division 3 of the Business&Professions IN,;TALL CLASS A DURO-LAST ROOFING SYSTEM 6.3SQ
Code and that my license is in full force and effect.
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,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 S Ft Floor Area:
Section 3700 of the Labor Code,for the performance of the work for which this q Valuation:$6630
permit is issued. APPLICANT CERTIFICATION /�
G APN Number:36946037.00 Occupancy Type:
I certify that 1 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 building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree too save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in c consequence the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regul9tions er a ertino Municipal Code,Section
9.18. Issued by: Date:
ature ti Date 7 /le) —
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All r)ofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspect' n,I ag t emove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspc ction.
will do the work,and the structure is not intended or offered for sale(Sec.7044, Sign uture ofAppli ant: Date:
Business&Professions Code) i
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's I haN a read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the Calil ornia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. coml liance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Addi tonally,should I use equipment or devices which emit hazardous air
permit is issued. contf minants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall main`ain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Heap h&Safety Code,S ction 5505,25533,and 25534.
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,I Own er or authoriz gent
become subject to the Worker's Compensation provisions of the Labor Code,I must Date: 71
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I here)y affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for wl tich this permit is issued(Sec.3097,Civ C.)
correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
the above mentioned property for inspection purposes.(We)agree to save Lends pr's Address
mnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
SignatureDate Licen:ed Professional
CITY OF CU?ERTINO
2 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 36946037 . 00
DATE ISSUED. . . . . . . : 06/30/2010
RECEIPT #. . . . . . . . . BS000010736
REFERENCE ID # . . . : 10060194
SITE ADDRESS 19803 PORTAL PLZ
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HAMIEL & MARYAM ZIARI
ADDRESS . . . . . . . . . . : 19803 PORTAL PLZ
CITY/STATE/ZIP . . . : CUPEFTINO, CA 95014
RECEIVED FROM . . . . : WM A FIALA
CONTRACTOR . . . . . . . : FRANP: R. FIALA LIC # 31229
COMPANY . . . . . . . . . . : FRANP: FIALA ROOFING INC
ADDRESS . . . . . . . . . . : 1228 QUARRY LN STE C
CITY/STATE/ZIP . . . : PLEAcANTON, CA 94566
TELEPHONE . . . . . . . . : (925) 484-0124
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---- ------ ---------- --
1BCBSC VALUATION 6, 630 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 6 . 00 78 .00 0 .00 78 . 00 0 . 00
---- ------ ---------- ---------- ----------
TOTAL PERMIT 79 .00 0 . 00 79 . 00 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ---------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF t V V10 ( q q-
CITY OF CUPERTINO
REROOF
c u P E RT i N o PERMIT APPLICATION
APN# � Date:3 (A q,�o
Building Address: i q W )
Owner's Name: ham'tA
e. �ca j6m2`fir' Phone#:
HOA: Yes El No ❑ If yes, provide letter from HOA H LA + 1 1 l - L `
Contractor: c C
t�J Phone #: a tj- Lj IF) 0
E'cis.C;•. t; �`c a\C� (� Fax#: q),Ib-
Cupertino Business License#: 1JIDL� Contractor License#: ��
Type of Roo f Covering:
Existing: Proposed:
I Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles•
❑ Other(Specify) qp Other(Specify)Ol',l 0-,LLL
Number of existing coverings on e ❑ Provide I.C.C.E.S. Report# L f z�-
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
em �c� L�.� �1� r �c t r y
I'1 S�C�`� C1 �l5 I - r►J�4 if L ct_s `c,(�,'t-1
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist& attach it to the application or if there are any restrictions: ❑
a licable, include in plan set & the sheet index.
Valuation:
Duh c� G(0 3 n
ls' •i
I Have Read, Understand and Will Com ly with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
REROOF TEAR-OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMEN'-• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408)777-3333•buildirn�a cupertino.orp
PROJECT ADDRESS i n �j �l�C; 6 rAPN#
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STREET ADDRES�n 1 ri CIT TATE, IcP FAX
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CORACTOR NAM LICENSE NUMBER LICENSE TYPE BUS.LIC.H i9
COMPANY NAME, E-MAIL` i FAX ,`U y,-
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable p•ovisions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimurr of one day before the requested inspection date.
Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon-Fri).
3. Tear-off roof inspection is required. Please call for tear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and al: dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available within one hour.
There are special hours for this service: 7:30 — 10:_Oam and 1:00—3:30pm (Mon—Thurs);
7:30 — 10:_ Oam and 1:00 —2:30pm(Friday).
4. If plywood is installed, a plywood nailing inspection is required.
5. In-Progress roof inspection is required. Call for ar. in-progress roof inspection to verify building is
weather tight after installation of approximately 25% of the roofing material.
6. New roof coverings shall not be applied without first obtaining all inspections 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 I he sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtained from the building inspector when the re-roofing is
complete. To receive a final sign-off, the following i;ems will be verified:
a. Flat roofs shall have a minimum of'/4" per foot c f slope and must demonstrate there is no ponding.
b. Listings from approved testing agencies for all p-e-manufactured products used shall be available
on-site to review at the time of the inspection.
c. Proper spark arrestor installation.
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-in:pection fee shall be paid before another
inspection can be scheduled.
3y 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 a o 1 with the re-roof policy stated bov .
Y p Y
Signature of Applicant/Agent: Date: � 1O 'Z Ole
ReroofPolicy_2010.doc revised 05/17/10
CITY OF
CITY OF Ct]?ERTINO
vkREROOF
CUPERTtNO FEE SCHEDULE
Number of Fee 11D Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Resi3ential B
_30 s - 1REROOFMRES Re-roof Mull i-Family B 1M]FDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
LCommission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B