10060071 CITY OF CUPERTINO :BUILDING PERMIT
BUILDING ADDRESS: 19820 PORTAL PLZ CCNTRACTOR:FRANK FIALA ROOFING PERMIT NO: 10060071
INC
NNER'S NAME: D.TING&Y.CHAN 12,8 QUARRY LN STE C DATE ISSUED:06/10/2010
OWNER'S PHONE: 4089738833 PL?ASANTON,CA 94566 PHONE NO:(925)484-0124
❑ LICENSEED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL
11
License Class G / Lic.# 6 t7 Wnrl 70 7 R E-ROOF FOR BUILDING A=REMOVE OLD BUR AND
INSTALL 1/4" DENS DECK,CLASS A,DURO-LAST
r
Contractor�7I awle KAA Date 4 /D ROOFING
I hereby affirm that I am licensed under the provisions of Chapter 9 SYSTEM
(commencing with Section 7000)of Division 3 of the Business&Professions
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. Sq Ft Floor Area: Valuation:$1105
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 APN Number:36946040.00 Occupancy Type:
permit is issued.
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 180 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 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
�—' Date:
granting of this permit. Additionally,the applicant understands and will comply Issued by.
with all non-point source regulations per the Cupertino Municipal Code,Section _
9.18.
D �,� `e RE-ROOFS:
mature Date �/ Ile Al. roofs shall be inspected prior to any roofing material being installed.If a roof is
ins talled without first obtaining an inspection,I agree to remove all new materials for
ins pection.
❑ OWNER-BUILDER DECLARATION
SiI nature of Applicant: Date: MO he
I 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 of the 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)
I,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. I will
I hereby affirm under penalty of perjury one of the following three mi intain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's m:terial. 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 of the work for which this permit is issued. wi 1 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by thr Health&Safety Code,Sections 25505 553 and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this 6�P/�
permit is issued.
01vner or authorized agent: Date:
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,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I h=by affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. we rk's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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
building construction,and hereby authorize representatives of this city to enter
>n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
.ademnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Li,;ensed Professional
9.18.
Signature Date
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBC ONTRACTOR LIST
JOB ADDRESS: Pxo PERMIT# O
OWNER'S NAME: 1—i'A" r, 4- y I r, PHONE # ( Z5 GENERAL CONTRACTOR:CONTRACTOR: —/, — , ; BUSINESS LICENSE#
ADDRESS: &e J CITY/ZIPCODE:
*Our municipal code requires all businesses working in the --ity to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INS1'ECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using Y an subcontractors:
Signature Date
Please check applicable subcontractors and complete tie following information:
SUBCONTRACTOR BUSINESS 1\AME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum/Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
W/X0 /0
Owner/Contractor Signature Date _
CITY OF CUEERTINO
3 ITEMS OF 18 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Iot :
APN 36946C40 . 00
DATE ISSUED. . . . . . . : 06/10/ 2010
RECEIPT #. . . . . . . . . BSOOOC10608
REFERENCE ID # . . . : 10060( 71
SITE ADDRESS . . . . . : 19820 PORTAL PLZ
SUBDIVISION . . . . . .
CITY CUP='INO
IMPACT AREA . . . . . .
OWNER D. TING & Y. CHAN
ADDRESS . . . . . . . . . . : 19820 PORTAL PLZ
CITY/STATE/ZIP . . . : CUPER"INO, CA 95014-3363
RECEIVED FROM . . . . : FRANK FIALA ROOFING
CONTRACTOR . . . . . . . : FRANK R. FIALA LIC # 31229
COMPANY FRANK FIALA ROOFING INC
ADDRESS . . . . . . . . . . : 1228 QUARRY LN STE C
CITY/STATE/ZIP . . . : PLEASj�NTON, CA 94566
TELEPHONE . . . . . . . . : (925) 484-0124
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---- ------ ---------- ---------- ----------
1BCBSC VALUATION 1, 105 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 1, 105 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1REROOFMRE SQ FEET 7 . 00 91 . 00 0 . 00 91 . 00 0 . 00
---- ------ ---------- ---------- ----------
TOTAL PERMIT 92 . 50 0 . 00 92 . 50 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
CtTY OF
CITY OF CUPERTINO
12 REROOF p W07 1
C U PE RT i N o PERMIT APPLICATION
APN# Date:
Building Address: I q q )0 PbYJC� Plo-c"_
Owner's Name: D'�I £ C han Phone#:
HOA: Yes E!T No If yes, provide letter from HOA qc)� - q -f 3 --9 D3
Contractor: I-`(' \(— V 1 ecta O k-VXJ Z,/\C1 ; Phone #:CAacj,- Lj1P)+.G t
OLt(Lff t4 Q_
Fax#: -�-
Cupertino Business License#: c� Contractor License
Type of Rooi'Covering:
Existing: Proposed:
Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles.
❑ Other(Specify) V Other (Specify)Oj, l 01-L6 �.
Number of existing coverings 04K4t ❑ Provide I.C.C.E.S. Report# �=E
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: i o S y `t I. c�rvs, ..
r r
�5
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: ❑
applicable, include in plan set & the sheet index.
Valuation: e-c
lC �p ly'
I Have Read, Understand and Will CompI with Cu oertino'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
CUPER'TINO 10300 TORRE AVENUE-CUPERTINO, CA 9.014-3255
(408)777-3228- FAX(408)777-3333-buildinci(acupertino.ong
PROJECT ADDRESS ' O �/U ��ZCI� APN#
OWNERNAME 11,^„ �^� � PHONE 14 1 lO,C 3�_ -MAIL
STREET ADDRESS O O . C i I, I> LJ l CITY, STjK�fE,QIP D r .n� q Sol FAX
CORACTOR NAM fr� _ LICENSE NUMBER, i LICENSE TYP BUS.LIC.N 1
C' lX^Tt�1c ..1.11 kJo-
'1
U
COMPANY NAME E-MAIL FAX
,c�1cL �e<f kn T-AQ_ nt �1�a5 � t1-�
STREETr� c3. ULCI tr La �-' Y� ZIt l 1'1 q
�1'1 t 1 P`�NE
a,5_
L4g i,_ C f o 14
I UNDERSTAND AND AGREE; TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable pr)visions of the 2007 California Building Code.
2. You must schedule all needed inspections a minimum 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 :ear-off inspection after the roof is torn off and all
the nails/fasteners have been removed. Any and all dry-rotted wood shall be replaced prior to this
inspection. A building inspector will be available witl Lin one hour.
There are special hours for this service: 7:30 — 10:30am and 1:00 — 3:30pm (Mon—Thurs);
7:30 — 10:30am 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 an in-progress roof inspection to verify building is
weather tight after installation of approximately 25% cf the roofing material.
6. New roof coverings shall not be applied without first c btaining all inspections and written approvals
from the building inspector. Any roofing which is app lied without first obtaining an approved inspection
will require the removal of all new material down to tl.e 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 itt ms will be verified:
a. Flat roofs shall have a minimum of I/4" per foot of slope and must 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.
8. NOTE: If you call for a tear-off or plywood nailing ir.spection 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.
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 an r coipply with the re-roof policy state above.above.
Signature of Applicant/Agent: Date: l0/,®A,010
ReroolPolicy_2010.doc revised 05/17/10
CITY OF
CITY OF CUPERTINO
REROOF
tal
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1C0MMLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
IBSEISNIICO Seismic C.orrmercial B
1REROOFRES Re-roof Resi3ential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISNIICRE Seismic Residential B
1REROOFNIRES Re-roof Multi-Family B 1MFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISNIICRE Seismic Residential B
1 BUSLIC Business License B