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10060191 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19910 PORTAL PLZ CON"RACTOR:FRANK FIALA ROOFING PERMIT NO: 10060191 INC I"VNER'S NAME: CHIA-FU&YEW-CHING CHEN 1228 QUARRY LN STE C DATE ISSUED:06/30/2010 v vt✓NER'S PHONE: 4082576151 PLE�.SANTON,CA 94566 PHONE NO:(925)484-0124 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT F PLUMB F License Class ce—_7 _ Lic.#/O/ �0 ;7MECH I— RESIDENTIAL[_ COMMERCIAL Contractor r&t,k/z !�T fin X 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. y INST.kLL 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 whi h this permit is issued. Occu Occupancy Type: APN Number:36946008.00 P Y 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 e the Cupertino Municipal Code,Section 9.18. �7 Issued by: Date: c;mature /� Date / ///d ❑ OWNER-BUILDER DECLARATION RE-ROOFS: All r Hofs 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 installed without first obtaining an inspectio I agr o remove all new materials for the following two reasons: insp xtion. 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, Sign ature I Applicant: Date: Business&Professions Code) — 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). 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 forma Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. corr 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 Safi ty Code,Section 25532(a)should I store or handle hazardous material. Adc.itionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this 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 1 certify that in the performance of the work for which this permit is issued,I shall Hei Ith&Safety Code,Sectio 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 Owner or authoriz gent- 711bc 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 reby 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 which 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 n the above mentioned property for inspection purposes.(We)agree to save Leu Lder'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 uu Aerstand 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 36946008 . 00 DATE ISSUED. . . . . . . : 06/30/2010 RECEIPT #. . . . . . . . . : BS000010736 REFERENCE ID # . . . : 10060191 SITE ADDRESS . . . . . : 19910 PORTAL PLZ SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHIA-FU & YEW-CHING CHEN ADDRESS 19910 PORTAL PLZ CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : WM A FIALA CONTRACTOR FRANK R. FIALA LIC # 31229 COMPANY FRANK FIALA ROOFING INC ADDRESS . . . . . . . . . . : 1228 CUARRY LN STE C CITY/STATE/ZIP . . . : PLEASFNTON, CA 94566 TELEPHONE . . . . . . . . : (925) 484-0124 FEE ID UNIT QUANTITY AMOLNT 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 8F I vv �p Cl CITY OF CUPERTINO Rr EROOF CUPERTINO PERMIT APPLICATION APN# Date: ObX - I �p/;?-,q 1A 0 4�2 Building Address: C 1 � P I(,-L '81-6/ Owner's NamePhone#: HOA: Yes 9 No If yes, provide letter from HOA Contractor: `F rc�.�1� 1 c�lc� c V10 TI1G . Phone #:q a.co-,- L j(F)4-0 �a. 4 Q,C:tSC Ccs. 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 Shakes ❑ Wood Shapes ❑ Wood Shingles ❑ Wood Shingles. ❑ Other(Specify) X Other(Specify)Wo-Lc.S Number of existing coverings Okic, ❑ provide I.C.C.E.S. Report# E b�-i 6 0 To.be Removed a Provide Mfgr. Installation Specs. Job Description: eo�' •l�l• rn ^L 0 �t i I y c, tuy--- L �IWcxyfLS s Residential Commercial Green Building: Please complete relevant.portion of the Confirmed with Planning Dept. if Green Building Checklist &#tach it to the application or if there are any restrictions: ❑ applicable,include in plan set & the sheet index. Valuation: $ ��— yj" 00 I Have Read,Understand and Will Comply with Cupertino's Tear-Off Policy: 7— Signature Revised 02105109 CITY OF CITY OF CUPERTINO [I RERGOF CUPERTINO FEE SCHJEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission l,ee 1BSEISMICO Seismic Commnercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B sf 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1 BUSLIC Business License B REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE-CUPERTINO, CA 55014-3255 cupt. O (408)777-3228- FAX(408)777-3333-builg!r g(Mcupertino.gr4 PROJECT ADDRESS ('} i O 6 Z� R i.J TAPN f! OWNER N ME C r\ PHo1VA i Icy y, a tJ"4 ./_,, IE-MAIL L t YlC v 0 tL� STREET ADDRESS O Z CITY, ATE.ZI;� j ._@ �/\i FAX I I S 0 1 tr-t l �/ CO LICENSE NUMBER. {y p� LICENSE TYP BUS.LIC. CTOR AM N� 1 W��ns, 0 0'+ C - i COFAX MPANY N E-MAIL ( _t a n Z e. la sTlaa� ckry l-rJ C. IQAII c.r� P ' gq. ola� 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 minimurr. of one day before the requested inspection date. Please schedule inspections online or call (408)777-3 Z28 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 wilhin 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.appliedwithout first obtaining all inspections and written approvals from the building inspector. Any roofing which is ap?lied 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 fror.i 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%4"per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pie-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:)ection 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 aqX o c imply with the re-roof policy state ,above. Signature of Applicant/Agent: Date: �� ReroofPolicy_2010.doc revised 05/17/10