01090059CITY OF CUPERTINO
BUILDING DIVISION PERMIT
;. -' ', "- '
CONTRACOR INFORMATION:
i..
ILDINGADDll
I
PERMIT NO.
22999 STANDING OAK CT
LELON JACKSON CONSTRUCT
ON 01090059
NER'S NAME:
APPLICATION SUB DATE.
CHIANG GLORIA K AND MICHAEL
6290 TILLAMOOK DR
09/17/2001
ONE:
SANITARY NO.. CONTROL NO.
(408)225-2282
Z ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
L__.1 I__7
i LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing
Job Description
P
u�i with Senion]000)of Division lofthe Businessend Prot' Inn'Code. and my licenmo,
fail force and affect. ��bTtgt ka' - F
ADD 270 SQ.FT. & REMODEL.
Din
ULicense Claes Lic.k
Date camranar `r
�i ARCHITECT'S DFCLARATION
1 underswnd my plans shall he usetl as public records JUL 2
�3 Y13/
l OTr T�--'
Life med Professional
OWNER BUILDER m the Contract p
f� g �Il g pea
I hereby affirm that 1 am exempt from the Conaacmr's,t�nulLnw far th
a following reason (Section ]1131.5, Business vad Professions Code. Any fit"y or county
n
o which require a pem+it m construct, alter, improve, demolish, or repair my structure
$150000
Q .pro t t I rc tliawsiocam for t
Sense,
... .. _. _ _ __ ___._ _ __ _ -
g gjpp[q�p�
:',�.V!3ITj�ZJ1rL+::Ul74iyV
Valuation
(stain
do Use
- (tial ha lal an. dp r.pau II provisions of the Conwemrs Lcenu Law(Chaps 9
Contractor's
(comm ngwith Srci °n ]000)of Division3nfthe Bus ness and Prokss ons Cod)
or that Ke is diarom therefrom and the basis far the alleged exonpmn. Any violation
—of Section 7031.5 by any applicant for a permit subjects the applicant m a civil penalty
mfnoumoremanfivenaodreaammrs(ssoo)'
10l1"NNMN*DATION
Occupancy Type
°1, as owner of the properly. or my employees with wages as their sole compensation,
will" do theework; -and ' the structure is not intended cr'olfcrea' far' sale (Sea 70il'
'(Business and Professions Code: The Cosmic, s License Law docs not apply to an
-
103 - UFER Required Inspections l ' -- z-'
owner of proper y Who builds car improves thereon, and who does such work himself
r through his n mpl yea provided th t h _ p m. a t intended in
10 4 - REBAR
_
'bf(red for sale. If. howee thebilding 'p mem is .1d witty one yem'of
completion the owner -bolder will have the burden of proving that he did not build or
__._.._..-.,...,.. ._...
x
105 — ANCHOR BOLTS
cop f purposeofsale)
_
106 SEWER & WATER
xnwe°fthepropcn7a,Businssanmmcting Uhl sedcovtraaorsto
_ --
202 - UNDERFLOOR PLUMBING
consumer the project (Sec ]U44, Business d Professmns Code) The Contractors
License Law does not apply m an owner of progeny who builds or improves thereon,
.- .. ..,.
203 - UNDERFLOOR MECHANICAIi'i'
wha.contrects for oprolens.with a cantmnat(s).liecined pursuant to the..
c nim torSLanae La
"" 04 = UNDERFLOOR";FRAME"""
[imd.
❑lam p B�Pcf this, awn
205 - UNDERFLOOR INSULATION
Ow Dem It tG'0�
_n RKERS MPENSATIONDECLARATION
301 - ROUGH PLUMBING
302 — TUB & OR SHOWER
thereby atrmt ander penalty orxgary;one of me rauowmg aeemrnuon`'
303 - ROUGH MECHANICAL
I hada oad will maintain'a cemacata of Consent in self -insane for Wmkere
in action:"as provided for by Section 3]00 M the Labor Code, farthevemanaofrheworkforwhich
0"I'l
3 04 - ROUGH ELECTRICAL
msspermit is issued.
3055 _ FRAME
bade and will maintain Warker'a Con mumion insurance, ae regbined by Section
3 06 - HOLDOWNS
_ 3]00 of the Labor Cade, for the pedotmancc of tha work for which this Permit is
issue d My Work rs n Pol cy b a
307 INSULATION
Carrier. t a i " PolicY No ' "'
fTIFlCATION
ICER
< 308 SIiEETRO'CK
Pl`,
C OF EXEMPTION FROM
M WORKERS
9 i 4 i
309 EXTERIOR` LATH
„ INSURANCE
. .-_.. COMPENSATION INS
_
., --INTERIOR
310)?' -:-INTERIOR LATH
°
atiddo dnmbaeonleiaaiftne
p permit is for one hundred dollars
(stool calass.)
311 - SCRATCH COAT
cert fy @ i th ped tinct ' f th work for which th permit a suN I
_..:,..
...•,_. . •3.13' — ROOF � NAIL]&'-"';.-, < - -
shbll notemploy a y p any nznn r s es to becomesubject to me Workers--
P< m Lws of Calfm we
Geo
501 FINAL ELBC,
TR I CAL ' ENERGY
Nm _..
A bean(
.__._.__....50.2._.=...F-INAL PLiIMBING'�ENERGY..__...
TOAyLICANTPsoCom.e.mg is p Yansh:..
APPLICANT the WoT If aftermakm n this of methof E m to ush should
Dome subject p p 'ttohasindecon Coae'yodm t
'
.
503 - FINAL MECHANICAL ENERGY
forthwithe l m n i. onsorma emasnanb a anevak<a.
_.504--..FINAL--BUILDING" ENERGY_..___
v eo srrsuc 1oNLe OwencErvcY "'^"'
I herby umrm ih t ll nsw t ding agency fo thepedomiance'
505 - FINAL ELECTRICAL, -..
of the work for which th r sea (sty 3U9A ci�.c)
-, GAS
i Lend N me .. _ �v A ..
de Age es
.,..,506 _TEST
507 - FINAL PLUMBING-..,
, 5 l eco fy that'! have read this applicationand state that above.information is
508 - FINAL ME CHAN I CAL
correct. I agree to comply with all, city nod county, ordinances and state laws relating
t° building construction, and hereby authorize representatives of ibis city to enter upon
509 - FINAL GRADE
( the abo e l aFinnerty fpenia p rr ,
(W)agee iosn indemnify andkeph an ass theCty fCopmriohgeinat
510 - FINAL PLANNING
1 liabilities,judgments. costs and expenses which may in any y_ true against said
514 - F INA PU IC WORKS
City consequencenof the grant ng of this Permit
LICANT
f
ANDmr D
Issued by: Date
OURCE RFGI TONS l
�SC 1.46-0
1'
SPPmurt AUN
u WllthGnTON DOUbMag_LCOMP41'PITHALLNONPOINJ
nucle•• Dan, ,ter
;, RIA DISCLOSURE
future 'site m�oreo handle haysrdods matenel
Re -roofs
Of Roof
- as defined by theCupertino Mun lip. side Chapter 9.12. a d the Health d Safety'.
C°ae
....Type
yp
'. ❑Yes
., ..
All. roofs. shall be mspected,prior to any, roofing, mated al, being installed..
ry;t Will applicantthe ft building occupantuseequipmentordeviceswhich
it M1 Mos 'r c ma t s def ed by th Bay A a At Quality Management
If a roof is insialled4ithoutfirstobtaininganinspection;'I!agree;to'remove
met?
°Ye
all new materials .for insPechon Applicant understands and will comply with
1
all non -point source regulations
' ` 1 ha a read4he h erao c matenols rcq remenis Linde Chag, 695:of the
Califm Health&Sof ty Cod Schlans 550525533 and 255341vnderstend that
'f iheb ild does of curtend h eat t th tit ismy nt to notify the
... .,. _. .... .._... ... ... -
pact quite ht cost,
u o f e t pr n tssua f a C rt Tease f
ecu an
Signature of Applicant Date
les
`
.. . _ ._ _ ... ..._ - .__ _.- - .. _.- ._.
All roof coverings to be Class "B" or better
at , i D t
• . „:_,_, . OFFICE - .. ...... , - --
5
}.I
s
nua�usns, utsaoty\ FLFCVdId-
...� :..,..-... ........ .... .. ...,....
i UILDING.ADDRESS:
PERMIT NO.
22999 STANDING OAK CT
LELON JACKSON CONSTRUCTION
01090059
LPA NER'S NAME:
.APPLICATION SUB DATE
CHIANG GLORIA K AND MICHAE
M 6290 TILLAMOOK DR
09/17/2001
RHONE:
SANITARY NO. CONTROL NO,
253-6352
SAN JOSE, CA 953.23
RCHITECT/ENGINEER: PHONE#
BUILDING., PERMIT INTO
ADD 270 SQ.FT. & REMODE
•BLDG ELECT PLUMP uECH
INSPECTIONS DA'IF INSPI.C.
TO ARRANGE INSPECTION JOB DESCRII"I'ION
CALL 777. 3228 MONDAY - FRIDAY 34 HOLES RESIDENTIAL:
z FOUNDATION/PIERSM.D.S.
BEFORE REQUIRED INSPECTION. JOB ADDRESS _, SFDW'L 0 KITCHEN REMODEI
—
AND PERMIT # ARE NEEDED WHEN PHONING. D ADDITION ❑ PLUMBING RE -PIPE
UFER GROUND
❑ MULTI -UNIT J STRUCTURAL
yPAD/SET BACIf-!•L� /
RESIDENTIAL COA1n1ERCIALOTHER_ MODIFICATION
GARAGE SLABS/PRFGUNITF.
D INTERIOR :1 CHIMNEY REPAIR
_
- -- --
5 POUR NO i r'INC RETE U'Cl"IL ADC A'F I IAS BERN' SIl1:iED
HAZARDOUS FIRE AREA IMPROVEMENT L7 SWIMMING POOLS
p UNDERGROUND/SLAB
ElYES It.c. - I aodantund Chet o Cm.. A roof...,,uh.d G BATH REMODEL/REPAIRC DEMOLITION
❑ OTHER
t PLUMBING
11 NO Initial LC.BA. #
c ELECTRICAL
a 0+111. ABOVE HAS BEEN SIGNED
EXISTING ROOF COVERING COMMERCIAL:
.yOyOT.POUR.FLOOR
❑ NEW BLDG/ADDITION 'u DEMOLITION
'PLUMBING'
Nmnherofcsimog c.,,rings CI TENANT O FOODSERVICE
MECHANICAL
MECHANICAL ...
IMPROVEMENT ,
ELECTRICAL
To he rcmoced To he retained ❑ OTHER
FRAMING VENTS
INSULATION
PLACE NO SU B FLOOR 1, N1 Il_AIt OVE If AS BEEN SIGN _)
TYPE OF ROOF COVERING
I ROOF SHEATH/DIAPHRAM O
PROPOSED:
PLUMBING
❑Buih-Up Rnnl' ❑ Buih-Up Roof
TUBS & SHOWER PAN
L Asphalt Shingles ❑ Asphalt Shingles
MECHANICAL p/
0 Wood Shakes ❑ Wond Shakes
- ELECTRICAL/POOL BON16
❑ Wood Shingles ❑ Wood Shingles
FRAMING/STAIRS/E. EGRESS
❑ Other(Specity) ❑ OtherlSpecify)
_ INSULATION/VENTILATION
Prnride LC.B.O. Report No.
'OVER NO WORK UNTIL ABOVL HAS EGL:' SIGNED
Pnovide Mfgr. Installation Specs.
XTERIAL SHEAR/HOLD DOWN
' JNTERIOR SHEARfHOLD DOWN
INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE INSP
SHEETROCK/SHEETROCK SHEAR
EXTERIOR LATHI/W-SCREED
SHOWER LATH
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
,
..SCRATCH COAT .
5.
. SEWER/WATER.
.TEMPORARY APPROVALS
' OCCUPANCY
l
ell
.FINNS
. PLANNING 777-3308
`
z
O/✓
ti .-GRADE(P.W. 777-3354)
FIRE' .
..
..HANDICAP
ELECTRICAL
S
PLUMBING'
. MECHANICAL-.
A ..ENERGY
... VISUAL FINAL ONLY
..BUILDING.:.'
'. 6WIPANCY OF BUD.DING'IS.NOT PERMITTED - ...
bN'T(L;:B! 6 LDING FINAL IS SIGNED BY BUILDING
CERTIFICATE OF OCCUPANCY ❑
" FRE -INSPECTION: - _' PLYWOOD: IN -PROGRESS
I.
.INSP."' - DATE . INSP.
DATE INSP. DATE
_ TE'AR'OFF INSPECTION:. BATTENS:
FINAL: _
INSP. DATE INSP.
DATE INSP. - DATE
- NOTE: OSHA APPROVED ACCESS
TO ROOF SHALL BE PROVIDED FOR INSPECTION
APPLICANTS POSTING COPY
„R
CITY Of
CUPEI�TINO
•
October 07, 2003
Homeowner
22999 Standing Oak Ct.
Cupertino, CA 95014
10300 Torre Avenue
Cupertino, California 95014
Telephone (408) 777-3218
FAX (408) 777-3333
COMMUNITY DEVELOPMENT/BUILDING DIVISION
SUBJECT: Permit: #01090059, Addition
Dear Owner:
Our records indicate that the above listed permit is due to expire on November 07, 2003.
If due to circumstances beyond your control, you have been unable to schedule an
inspection, you may submit a letter to the City of Cupertino Building Official
requesting a one-time extension for his review. Please state in the letter the reasons for
your request If no extension is granted and no inspection is called before the expiration
date, this permit will be voided and the permit application discarded. After this point, you
will need to submit new plans for plan review and pay permit and plan check fees to be
issued a new permit.
If your records show that the permit card was signed and released by an inspector as
being complete and final, please notify this office at your earliest convenience. We will
update our computer files and close your permit, and we apologize for any inconvenience
this matter may have caused.
Thank you for your attention to this matter.
Sincerely, �n
CITY OF CUPERTINO
Christy Akatiff, Administrative Clerk
Printed on Recycled Paper
07/ � %/J_3