10060188 CITY OF CUPERTINO EUILDING PERMIT
BUILDING ADDRESS: 19892 PORTAL PLZ CONTRACTOR:FRANK FIALA ROOFING PERMIT NO: 10060188
INC
' "NER'S NAME: MAKARAND&ALKA KALE 1228 QUARRY LN STE C DATE ISSUED:06/30/2010
OWNER'S PHONE: 4083926062 PL&LSANTON,CA 94566 PHONE NO:(925)484-0124
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT r PLUMB l�
License Class / Li,.#
c � j MECH RESIDENTIAL COMMERCIAL r
Contractor r�a41 ,rJk&04,Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:BLDG D-RMV OLD B.U.R.INSTALL 1/4"DENS DECK.
INSTkLL CLASS A DURO-LAST ROOFING SYSTEM 6.3SQ
(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.
I have and will maintain Worker's Compensation Insurance,as provided for by Sq.f t Floor Area: Valuation:$6583
Section 3700 of the Labor Code,for the performance of the work for whic this
permit is issued. !//�rG
APN Number:36946011.00 Occupancy Type:
APPLICANT CERTIFICATION
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
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 to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN igO DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the L80 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations er the Cupertino Municipal Code,Section
9.18. ` Issu�d by:
Date:
°'-nature 7— Date 7/�
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All r)ofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one of insta[led without first obtaining an inspectio ,I a r to remove all new materials for
the following two reasons: insp(ction.
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, Sign iture o Ap licant: Date:
Business&Professions Code)
I,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 HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I ha✓e read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safe ty 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 Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. mai main compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,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 Ow rer or author iig
become subject to the Worker's Compensation provisions of the Labor Code,I must — Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I he eby 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,vhich 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 Len der's Address
.nnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I un ierstand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
2 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36946C11 . 00
DATE ISSUED. . . . . . . : 06/30/2010
RECEIPT #. . . . . . . . . BSOOOC10736
REFERENCE ID # . . . : 10060188
SITE ADDRESS 19892 PORTAL PLZ
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER MAKARZND & ALKA KALE
ADDRESS 19892 PORTAL PLZ
CITY/STATE/ZIP . . . : CUPER"INO, CA 95014
RECEIVED FROM WM A FIALA
CONTRACTOR FRANK R. FIAAA 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 AMO1JNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---- ------ ---------- ---------- -
1BCBSC VALUATION 6, 583 . 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
CITY OF CUPERTINO
IEROOF
CuPERTWO PERMIT APPLICATION
APN# Date: 4's
Building Address:
Owner's Name: 4 Phone#:
1�,tK-6 ru.jlct . A(kkci. IC&(�.
HOA: Yes g No If yes, provide letter frgm HOA
Contractor.: Ff6- 1 V l o-tcL Koott.Vx0 TjA.e, , Phone #:q a co-,- Lie),4 p 6
La-r
C�Cc S C _c;` J�Ce Fax#:
Cupertino Business License#: , Contractor License
Type of Roof Covering:
Existing: Proposed:
Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shames ❑ Wo-od Shales
❑ Wood Shingles ❑ Wood Shingles.
❑ Other(Specify) )( Other(Specify)- U f c &S P•
Number of existing coverings pl2 e ❑ Provide I.C.C.E.S. Report# E�
To.be Removed ❑ Provide Nlfgr. Installation Specs.
Job Descriptio S �( x..42, -
e+Mwo2� �L �' i tc �b1S ' " k.
leu V-0- Lo-s-�
Residential Commercial LJ
Green Building: Please eon�iete releaut pvrtiop of the Confirmed with Planning Dept. if
Green Bolding Checklist& ttach it to the appliiaation or if there are any restrictions: ❑
7aluation:
icabI include in Ian set & the sheet index.
s— yi, ®0
I have Read,Understand and Will Comply with Cupertino's Tear-Off- Policy:
Signature
Revised 4.2/05/49
CITY OF
CITY OF CUPERTINO
1121 RER43OF
CUPERTtNa FEE SCREDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Corrmercial B 1C0MMLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Res_dential B 1SFDWLR00F
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commissior Fee
1BSEISNIICRE Seismic Residential B
1REROOFMRES Re-roof Mu:ti-Family B 1MFDWLR00F
1BCBSC Cal Bldg St�mdards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business Li:,ense B
REROOF TEAR—OFF POLICY
�,...� COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE-CUPERTINO, CA 5014-3255
c uPWf'igo
(408)777-3228- FAX(408)777-3333 bUM1g(a cupertino.ora
PROJECT ADDRESS 6 R 1 I it APN#
OWNER NAME +' PH Z 3 0 E-MAIL
�l ,t,(- tlC� d (,(, F M e'. 11 U-�
STREET ADDRESS CITY, ATE,ZII �/\( FAX
CO CTOR AM LICENSE NUMBER. LICENSE TYP BUS.LIC.#
gc �"� C-
COMPANY N E MAI' FAX - gLf-01'15-a to a_rQLEA
STREET AD STATE,ZIP 7 PT;
NE p Ll L-f� le. Gay !A" �S�o�► .
I UNDERSTAND AND-AGREE TO THE FOLLOWING:
1. The re-roof project shall comply with all applicable p rovisions 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)777-3 7,28 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 infection 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 the sheathing so a proper inspection can be
performed.
7. A final inspection and approval shall be obtained fror.l the building inspector when the re-roofing is
complete. To receive a final sign-off, the following items 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 pi 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-ins Rection 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 o c snply with the re-roof policy stated�above-
Signature of Applicant/Agent: Date: V//Z q//0
ReroolPolicy_2010.doc revised 05/17/10