10060184 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19964 PORTAL PLZ CON TRACTOR:FRANK FIALA ROOFING PERMIT NO: 10060184
INC
NER'S NAME: XUGUANG BU&YINGYING ZHANG 1228 QUARRY LN STE C DATE ISSUED:06/30/2010
OWNER'S PHONE: 4082552281 PLE,►SANTON,CA 94566 PHONE NO:(925)484-0124
❑ LICENSED CONTRACTOR'S DECCLARATION BUILDING PERMIT INFO: BLDG ELECT r- PLUMB F
License Class Lic.# l'! 0170 � r
MECH RESIDENTIAL COMMERCIAL
Contractor��[ / /I�L,IIt/��Date
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.F t Floor Area: Valuation:$6583
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. &Z*
10 APN Number:36945031.00 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 1gO DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 1$0 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regul tions per e Cupertino Municipal Code,Section
9.18. Issu:d by: Date:
•iture Date
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All r rofs 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 inspection,I agree 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 tt p cant: /L— 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 Cali'ornia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. com iliance 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 Add tionally,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. 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,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 Owi er or authori en Date: Z///�
�
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I her 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%1hich this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Len ler'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 ler's Address
,.__cmnify 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 uni lerstand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUEERTINO
2 ITEMS OF 36 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36945C31 . 00
DATE ISSUED. . . . . . . : 06/30/2010
RECEIPT #. . . . . . . . . : BSOOOC10736
REFERENCE ID # . . . : 10060184
SITE ADDRESS . . . . . : 19964 PORTAL PLZ
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : XUGUAr"G BU & YINGYING ZHANG
ADDRESS . . . . . . . . . . : 19964 PORTAL PLZ
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : WM A F'IALA
CONTRACTOR . . . . . . . : FRANK R. FIALA LIC # 31229
COMPANY . . . . . . . . . . : FRANK FIALA ROOFING INC
ADDRESS . . . . . . . . . . : 1228 C!UARRY LN STE C
CITY/STATE/ZIP . . . : PLEASFNTON, CA 94566
TELEPHONE . . . . . . . . : (925) 484-0124
FEE ID UNIT QUANTITY AMOUNT 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 C UPERTINO
REROOF
C UPERTI NO PERMIT "I'LICA TION
Date:
Building Address:
E?wner's NamU t t 1 Phone #:
Name__:
�In�jytn IL �an� U`� - �SS �S'
HOA: Yes No If es IL
letter from HOA
Contractor; (�( k- 1 6 -kGLC �-AJ Phone - ` r�``�A Cy .
�Gt,S C Fax#: q�. -
Cupertino Business License#: � Contractor License : +®;�
31
Type of Rooi'Covering:
Existing: Proposed:
❑ Built-Up Built-Up Roof 1}roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes o Wood Shakes
❑ Wood Shingles ❑ Wood Shingles.
❑ Other(Specify) ( Other (Specify)b U(C) t S
Number of existing coverings Ort e ❑ Provide I.C.C.E.S. Report#
To.be Removed ❑ Provide Nifgr. Installation Specs.
Job Descriptio enno0 c •u• ,l� S�' - .y `` �.6`1S �'C.k..
s�a.�1 E 1cLss N. l�ugra lc�si� r�oo-(-L S s
Residential Commercial
Green Building: Please cow lete relevant partioa 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: r y3' ®®
I Have Read,Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 02/05/09
CITY OF
CITY OF CUPERTINO
REROOF
CUPERTINO FEE SCIHIDULE
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 Fee
1BSEISMICO Seismic Commercial B
1 REROOFRES Re-roof Res'dential B 1SFDWLR00F
1BCBSC Cal Bldg Stzndards B ALL PERMIT TYPES
Commission Fee
1BSEISMMCRE Seismic Residential B
6'_70 S7 4 1REROOFMRES Re-roof Mu:ti-Family B 1MFDWLROOF
1BCBSC Cal Bldg St.mdards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business Li;ense B
REROOF TEAR-OFF POLICY
A,...� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING,OFFICIAL
10300 TORRE AVENUE•CUPERTINO, CA 55014-3255
(408)777-3228• FAX(408)777-3333 bggo 9(a_cupertino.Org
PROJECT ADDRESS q Ce 0 6W Ra-Z6 R L APN#
OWNER NAME i,{u &It I nej j i n PH � E-MAIL
STREET ADDRESS C/+
CITY, ATE ZII FAX
CORACTOR AM LICENSE NUMBER. 0, �)-t LICENNSE 3 P BUS.LIC.N
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COME-MAIL �0.L1..r FAx
PANY N
C a %n e. as pl- t I
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REET AD C. l G STATE, Pr 0
la c�ry .
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:-Aam 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 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 from 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%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 cl nply with the re-roof policy stateed,above.
Signature of Applicant/Agent: Date: V11,2_,9110
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ReroofPolicy_2010.doc revised 05/17/10