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10060181 CITY OF CUPERTINO LUILDING PERMIT BUILDING ADDRESS: 19956 PORTAL PLZ CON TRACTOR:FRANK FIALA ROOFING PERMIT NO: 10060181 INC 'NER'S NAME: CHEE&SHIRLEY TUNG 1228 QUARRY LN STE C DATE ISSUED:06/30/2010 OWNER'S PHONE: 4088676447 PLE,6ANTON,CA 94566 PHONE NO:(925)484-0124 ❑ L`ICENSED CONTRACTOR'S DECLARATION BUI.DING PERMIT INFO: BLDG F ELECT[_ PLUMB License Class (, Lic.# _ / A � MECH r RESIDENTIAL r- COMMERCIAL� •� / • A ��_Date / l Contractor�/"G.r I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:BLDG K-RMV OLD B.U.R.INSTALL 1/4"DENS DECK. INST aLL 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.I t Floor Area: Valuation:$6583 Section 3700 of the Labor Code,for the performance of the work for whigh this permit is issued. APN Number:36945035.00 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 regula ions pelAk.Q.Cupertino Municipal Code,Section 9.18. � �� Issu-d by: Date: �ature Date o ❑ 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 obtainin:an inspect' n,I ag ee to remove all new materials for the following two reasons: inspt: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 itur f ph ant: Date: Business&Professions Code) j�� 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 HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I ha ie 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. coin 3liance 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 Additionally,should I use equipment or devices which emit hazardous air cont 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 th&Safety Code,$ectiqgL25505,25533,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 Owr ter or author' g 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 hei 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 N ihich this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Len ier'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 3er's Address innify 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. Lic<nsed Professional Signature Date CITY OF CUPERTINO 2 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: :,ot: APN . . . . . . . . : 36945035 . 00 DATE ISSUED. . . . . . . : 06/30,/2010 RECEIPT #. . . . . . . . . : BS000 )10736 REFERENCE ID # . . . : 10060L81 SITE ADDRESS . . . . . : 19956 PORTAL PLZ SUBDIVISION . . . . . . : CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHEE x SHIRLEY TUNG ADDRESS . . . . . . . . . . : 19721 SCOTLAND DR CITY/STATE/ZIP . . . : SARAT)GA CA, CA 95070-5031 RECEIVED FROM . . . . : WM A ?IALA CONTRACTOR FRANK R. FIALA LIC # 31229 COMPANY . . . . . . . . . . : FRANK FIALA ROOFING INC ADDRESS 1228 QUARRY LN STE C CITY/STATE/ZIP . . . : PLEASzNTON, CA 94566 TELEPHONE (925) 484-0124 FEE ID UNIT QUANTITY AMO:JNT 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 VTY Of CITY OF CZ UPERT, RERc SOF cUIPERT O PERMIT "I'LICATION Date., APN# h Building Address: l �� (� P64&Q t j Owner's Name: Phone #: j L.1()� - S from HPOA HOA: Yes No If e�Pkro vide Ie 4Contractor; F`(a-4-NC Phone I L3Fax#: ��-�- Cupertino Business License#: Contractor License - a-3-9 .# : 31 a-3-c� G Type of Rooi'Covering: Existing: Proposed: Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shiagles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles a Wood Shingles. ❑ Other(Specify) ( Other (Specify).b fc)-L/'CS i �. Number of existing coverings ©lZ e ❑ Provide I.C.C.E.S. Report# Tobe Removed a Provide Mfgr. Installation Specs. Job Descriptio evyw0e, �S�a.�1 lass leuira l,o sIr Residential Commercial Green Building: Please cow Tete relevant..portioii of the Confirmed with Planning Dept. if Green Building Checlist& Rich it to the application or if there are any restrictions: ❑ applic M include in plan set & the sheet index. Valuation: I have Read,Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF CITY OF CUPERTINO REROOF CUPER`INO FEE SCBEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Comnercial B 1COMMLROOF 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 63o s-� 1REROOFMRES Re-roof Mull i-Family B 1MFDWLR00F 1BCBSC Cal Bldg Staidards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business Lic,-nse B REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 cup it`i'y.No (408)777-3228- FAX(408)777-3333-bgkl gC�cupertino.org PRojEcr ADDRESS J G 5(0 O 6 Rawl_ R v-( ��TAPN Y ly� �1 �� PH . .)e a ?(,, - � +� EMAIL OWNERNAME C t J ,r 1 l �l S !� CITY, ATE.ZII Q�� FAX STREET ADDRESS i C,�( 'JO( C(Z�. �:.. ej GL ! `" CO CTOR AM �i u a CENSE NUMBER. LICENSE TYP BUS.LIC. t _ oft VA E-MAIL FAX a COM,PAMYN _l Q . C a�' �jL�- v� r1 C+.. I STREET AD STATE.ZIP �.f f 1 1 _ PN LJ y 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)777-3228 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 all dry-rotted wood shall be replaced prior to this inspection. A building inspector will be available wi&hin one hour. There are special hours for this service: 7:30 — 10:30am and 1:00—3:30pm (Mon—Thurs); 7:30 — 10::f 0am and 1:00—2:3 0pm (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%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 al plied without first obtaining an approved inspection will require the removal of,all new material down to-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 kerns will be verified: a. Flat roofs shall have a minimum of%4"per foot cf 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. 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�rnply with the re-roof policy stated,ab}ovve, Signature of Applicant/Agent: Date: iLi ReroojPolicy_2010.doc revised 05/17/10