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11080149 CITY OF CUPERTINO BUILDING PERMIT y ` Bt ILDIN'G ADDRESS: 19936 PORTAL PLZ CONTRACTOR:FRANK FIALA PERMIT NO: 11080149 ROOFING INC OWNER'S NAME: VENKATACHALAPATHY ANAND& 1228 QUARRY LN STE C DATE ISSUED:08/23/2011 .SOUNDARAR i'N'ER'S PHONE: 4085644490 PLEASANTON,CA 94566 PHONE NO:(925)484-0124 ❑ LICENSED CONTRACTOR'S DECLARATION F_ F_ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class ��� Lic. © F r– MECH RESIDENTIAL COMMERCIAL. Contractor k 2i A, ate g4ZL JOB DESCRIPTION: BLDG N-RE-ROOF 6 SQUARES-REMOVE OLD B.0 R. I hereby affirm that 1 am licensed under the provisions of Chapter 9 INSTALL 1/4"DENS DECK.INSTALL NEW CLASS A DURO (commencing with Section 7000)of Division 3 of the Business&Professions LAST ROOFING SYSTEM,INSTALL NEW 1/2"C.DX.PLYWOOD Code and that my license is in full force and effect. 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. Sq.Ft Floor Area: Valuation:$6500 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36945012.00 Occupancy Type: permit is issued. /"' !' APPLICANT CERTIFICATION !/ I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 18aDAYS 0 AST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Date granting of this permit. Addi 'onally,the applicant understands and will comply with Issue all non-point source regula s pe 'upertino Municipal Code, ec77tion 9 18. Signature ------- -- —Date_ Jl RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. if a roof is OWNER-BUILDER DECLARATION installed without first obtaining an inspe tion,1 ree to remove all new materials for 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of inspection. _ / the following two reasons: Signature of Applicant: Date: `� L 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, ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE 1 hereby affirm under penalty of perjury one of the following three declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. 1 will Compensation.as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the performance of the work for which this permit is issued. Health&Safety Code,Section 25532(a)should 1 store or handle hazardous I have and),%Ill maintain Worker's Compensation Insurance,as provided for by material. Additionally,should 1 use equipment or devices which emit hazardous Section 3700 of the Labor Code,for the performance of the work for which this air contaminants as defined by the Bay Area Air Quality Management District Permit is issued. will maintain compliance with the Cuperti o Municipal Code,Chapter 9.12 and 533, n I certify that in the performance of the work for which this permit is issued,1 shall not the Health&Safety Code,Sections 2550 5534. employ any person in any manner so as to become subject to the Worker's Owner o thorize agent: Compensation laws of California. If,after making this certificate of exemption,I Date:J� 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 hereby affirm that there is a construction lending agency for the performance of I certify that I have read this application and state that the above information is work's 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 upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, is,and expenses which may accrue against said City in consequence of the ting ol'this permit.Additionally,the applicant understands and will comply with i,li non-point source regulations per the Cupertino Municipal Code,Section 9.18. ARCHITECT'S DECLARATION SignatureDate I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 15 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp : Rng: Sub: Blk: Lot : APN . . . . . . . . : 36945012 . 00 DATE ISSUED. . . . . . . : 08/23/2011 RECEIPT # . . . . . . . . . : BS000014535 REFERENCE ID # . . . : 11080149 SITE ADDRESS . . . . . : 19936 PORTAL PLZ SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : VENKATACHALAPATHY ANAND & SOUN ADDRESS . . . . . . . . . . : 19936 PORTAL PLAZA CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : WILLIAM FIALA CONTRACTOR . . . . . . . : FRANK R. FIALA LIC # 31229 COMPANY . . . . . . . . . . : FRANK FIALA ROOFING INC ADDRESS 1228 QUARRY LN STE C CITY/STATE/ZIP . . . : PLEASANTON, CA 94566 TELEPHONE . . . . . . . . : (925) 484-0124 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - ------- -- ---------- --- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 6, 500 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 6 , 500 . 00 0 . 65 0 . 00 0 . 65 0 . 00 1REROOFRES SQ FEET 6 . 00 84 . 00 0 . 00 84 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 85 . 65 0 . 00 85 . 65 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- --- --- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 GU Ef>TIN4 (408)777-3228• FAX (408)777-3333•building cIokupertino.org PROJECT ADDRESS �(A � �j •, � � �� � ! � APN# ON'NERNAME ���,^ A41010E�a - �_I I E-MAIL ,pMtQ V 841 KA STKEFTADDRESS "lo CO'JTACT NAME PHONE `J E-MAIL STkE17 ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT *CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER 7�❑ IT�yENANT CGNTKACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC d P Y E-MAIL FAXq� � STt 'T ES tf/ I P ARCHITECT/ENGINEER NAME J LICENSE NUMBER BUS.LIC P L CO MP ANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex Multi-Family ROOF AREA: VALUATION: / STRUCTURE: ❑ Commercial I `-� EX!STING ROOF TYPE: 1IJRUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE `WYES IF NO. PLYWOOD %95w, ❑ PLYWD ❑ OSB PITCH: ROOF ❑NO #LAYERS: THICKNESS: 5/8" TYPE: CDX �•12 CLASS: A 1"Vv- ICC-ES REPORT# PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES El WOOD SHINGLES `OTHER L J_ DESCRIPTION OF WORK: 1� Q- Z N �y w 6L)Ct ov`e 00 h'a. RN% Ul\ 1411 L. <;�q,�Ae_vy_N Yea o wr.t 0j, rvP_Z ck Q.Q 4Z Irc • o _1� o.- Vt By my sign re below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this application and the information I have provided is correct. I have r9ad the D i tion of Work and verify it is accurate. I agree t comply with all applicable local ordinances and state laws relating to building construction. I aut e r tatives of Cupertino to enter the above-I ntified roperty for inspection purposes. Signature of Applicant/Agent: Date: �� SUPPLEMENTAL INFORMATION REQUIRED 14 '�` Q ki ., 1 :' � QWr[�I11K_2*1 ...j.7 _ I f building is associated with a Home Owner's Association,provide letter ry i °� of approval from HOA. xyHr tt ���>•�B"1; I,DINC PLAN4REVI�`W` a �w � t. _ Provide Planning approval to verify if there any restrictions. r l +, r � v Z � J P] NNING PLAN IFEVtr W -w z1 . rnxdy 4' .r rok� Provide copy of Manufacturer's Installation Specifications. PY of Cu ' Provide signed co ertinos Tear-Off Policy. k t -- g Pt .m. i3gl��.kEdrt'YGF�'cuai."a(Lv + .i t�' iM?a ReroofApp_2011.doc revised 03/16/11 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 CUPERTINO (408)777-3228- FAX (408)777-3333• !c',i ,: t1;.,µ_, = t.rtr; +N: PROJECT ADDRESS ' 96 Py r L P APN# OWNER NAME / PHONE I 0 E-MAIL Y -'- STREET ADDRESS /n TY, STATE,ZIP /� �Q FAX CONTRACTOR NAMEj������ �i-' / LICENSE NNUMBER ��;®..7 LICENSE TYPE BUS-L1C. CO NY NAME /- , E-MAIL STREET ADDR SS a CITY,STATE,ZIP ,az I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday)to schedule the next day inspection. For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Progress and Final Inspections will be given a two hour window. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked-down or removed prior to this inspection. 4. If plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection 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. 6. Progress Inspection is required when approximately 50% of roof covering is installed. 7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 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 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, vents painted, gutter/downspouts installed, debris removed. 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 and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors ar require installed in accordance with Sections R314 and 8315 of the 2010 California Residential Code. - lie /� Signature of Applicant/Agent: Date:_ / ReroofPolicy_201 1.doc revised 02/16/11