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10060189
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19900 PORTAL PLZ COT4TRACTOR:FRANK FIALA ROOFING PERMIT NO: 10060189 INC --"NER'S NAME: HWEI MIEN 1221 QUARRY LN STE C DATE ISSUED:06/30/2010 t,vVNER'S PHONE: 6506105208 PLf ASANTON,CA 94566 PHONE NO:(925)484-0124 ❑ LICENSED CONTRACTOR'S DECLARATIONF e� BU LDING PERMIT INFO: BLDG ELECT PLUMB License ClassLic.# J �Q 7 MECH r— RESIDENTIAL I— COMMERCIAL� Contractor 1., � Ah1a� I hereby affirm that I am licensed under the provisions of Chapter 9 JOI9 DESCRIPTION: BLDG D-RMV OLD B.U.R.INSTALL 1/4"DENS DECK. (commencing with Section 7000)of Division 3 of the Business&Professions INS"'ALL 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 Sq. Ft Floor Area: Valuation:$6583 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APl'1 Number:36946012.00 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 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. - Isst ed by: Date: c=-nature Date 7// ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All oofs 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 Inst,Iled without first obtaining an inspection,I ee remove all new materials for the following two reasons: insp-ction. 1,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, Signature f A plicant: '`-- Date: Business&Professions Code) 711_ 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(See.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 have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the Cal fornia Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. con pliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safvty 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 Ad6tionally,should I use equipment or devices which emit hazardous air con:aminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain 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 Hea lth&Safety Code,Sectio s 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's 7 Compensation laws of California. If,after making this certificate of exemption,I Ow ter or auth _age ��`/b become subject to the Worker's Compensation provisions of the Labor Code,Imust — 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 Lender'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 3erstand my plans shall be used as public records. 9.18. Lia!nsed Professional Signature Date CITY OF CUPERTINO 2 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: ]got: APN . . . . . . . . : 36946012 . 00 DATE ISSUED. . . . . . . : 06/30,'2010 RECEIPT #. . . . . . . . . : BSO00010736 REFERENCE ID # . . . : 10060:_89 SITE ADDRESS . . . . . : 19900 PORTAL PLZ SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPER"INO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : HWEI HIEN ADDRESS . . . . . . . . . . : 19900 PORTAL PLZ CITY/STATE/ZIP . . . : CUPER"INO, CA 95014 RECEIVED FROM . . . . : WM A MALA CONTRACTOR . . . . . . . : FRANK R. FIALA LIC # 31229 COMPANY . . . . . . . . . . : FRANK FIALA ROOFING INC ADDRESS . . . . . . . . . . : 1228 ()UARRY LN STE C CITY/STATE/ZIP . . . : PLEASANTON, 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 1;Z.3TYOF CITY OF Ci TERTWO RFRO)OF tl--1,1_1 I C❑PEATMO PERMIT APPLICATION APN# Date: / 9 oz®`® Building Address: r3 ��c�Q 16LZ,CA.... Owner's Name: a Phone#: HOA: Yes No if es, rovide letter from HOA Contractor: Y'�.;(1 10-t6 CJc: �°� � ' Phone #:q 3 .- Fax L4bq- L Cupertino Business License. Contractor License : � � Type of Rosi'Covering: Existing: Proposed: Built-Up Roof o Built-Up roof ❑ Asphalt Shingles a Asphalt Shingles ❑ Wood Shakes o Wood Shaves ❑ Wood Shingles a Wood Shingles. ❑ Outer(Specify) XOther(S eci )�U(O LA ?- V c Number of existing coverings ©IZ e ❑ Provide I.C.C.E.S. Report# c:F.S-I L-, ( To.be Removed a Provide Mfgr. Installation Specs. Job DescriptioE Fenixo0e, To S-6_�t ' L( I' bels kris. N u Y-0 L t�.S�' r ti 00C>`t-� S �'►� c� Residential Connnercial Green Building: Please conlete relevant pvrdoa,of the Confirmed with:Planning Dept. if Green Bolding Checklist & tach it to the appli cation or if there are any restrictions: ❑ applicableLinclude in plan set & the sheet index. Valuation: I Have Read,Understand and Will Comply with Ci:pertino's Tear-off Policy: Signature Revised 0.2/05149 CITY OF CITY OF CUPERTINO 12 REROOF CUPERTINO FEE SCINDULE Number of Fee ID Fee Deseri ption Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMIVILROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISM1C0 Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg St.mdards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B �_� _v f 1REROOFMRES Re-roof Mu.ti-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commissiori Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION .Is ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 55014-3255 C UAht'-li U (408)777-3228 FAX(408)777-3333•buildirg(a�cupertino.ora PROJECT ADDRESS C \� O 6 .2./• R1C( � APN k OWNER NAME `J 1 IJPHOK:e ^. .��Gq E-MAIL ien STREET ADDRESS C C �. 71 Lgi*�i VW0 1_�a_ CITY. ATE.ZIl iL.— 9 4(g FAX CO CTOR NAM ,[[�� LICENSE NUMBER. p p' y LICENSE TYP BUS.LIC.1$ 1 n flivl� 0 . V-1 C" FAX i 7 COMPANYN E-MAIL as- gL,- �5 a STREET AD STATE.ZIP q.f f s t! P O �" g p q, u 6 1 I UNDERSTAND AND-AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions 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)777-3 228 between 7:30--3:30 (Mon-Fri). 3. Tear-off roof inspection is required. Please call foi 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::,0am and 1:00—3:30pm (Mon—Thurs); 7:30 — 10::,0am 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 ofall new material down to the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained front the building inspector when the re-roofing is complete. To receive a final sign-off, the following it ems 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 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 o clonply with the re-roof policy stated,above, //,x,9//r Signature of Applicant/Agent: Date: b ReroofPolicy_2010.doc revised 05/17/10