NO PERMIT NUMBER �p.L City of Cupertino
• lll��� 10300 Torre Avenue
Cupertino,CA 95014-3255
CITY OF Telephone: (408)777-3228
CU P E IST I N O FAX: (408)777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: February 16, 2006
RE: Address Change (APN #326-33-097)
• Please note the following address change: 10268 Bandley Drive has added the
following suite numbers; 101, 102, 103, 104, 105, 106, 107, & 108. Please update your
records accordingly.
The new address will take effect immediately. If you have any questions, please call
me at (408) 777-3246.
Sincerely,
Susan Winslow
Administrative clerk
•
Printed on Recycled Paper
Community Development Department
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408) 777-3333
•
CHANGE OF ADDRESS/ADD SUITE NUMBERS
REQUEST FORM
NAME (please print): A U ( n —Pf� IZ Kj
TELEPHONE NUMBER:
APN (assessors parcel #):
EXISTING ADDRESS:
NEW ADDRESS REQUESTED:
101 � 02 103 , t o4 loss l 06
NEW SUITE NUMBERS REQUESTED: 1 0:Z I og
Request for address change will be approved only if the change meets the following
criteria:
• 1. The change of address will not create confusion.
2. Only the LAST DIGIT will be considered.
3. The odd/even addressing system will be maintained.
4.. Suite numbers must be NUMERIC.
5. The change of address will not result in a public safety hazard.
6. PROOF OF OWNERSHIP IS REQUIRED. (Ex. property tax bill)
The fee for a change of address/addition of suite numbers request is
$268.00. The fee is due with this request form and will not be refunded if
the request is denied.
The direct costs associated with an address change/addition of suite numbers request
will be borne by the applicant. Approximate review time is fifteen (15) days. If the
address change is granted, the new address will be in effect thirty (30) days following
roval.
SigriAture Date
CITY OF CUPERTINO
P� 1 of 1 MISCELLANEOUS RECEIPT
RECEIPT # : 32748 PRINT DATE : 01/10/2006
PRINT TIME : 15 : 35 : 56
RECEIPT DATE : 01/10/2006 OPERATOR :counter
COPY # : 3
RECEIVED BY : counter CASH DRAWER: BS1
REC 'D. FROM : DAVID PERNG
USER 1
USER 2
NOTES : ADD SUITE #101 THRU 108 10268 BANDLEY
FEE ID AMOUNT THIS RCPT BALANCE
ZADDCHG 268 . 00 268 . 00 0 . 00
TOTALS : 268 . 00 268 . 00 0 . 00
METHOD OF PAYMENT - -AMOUNT--- NUMBER
----------- ------------------
0 , R 268 . 00 VISA
TOTAL RECEIPT 268 . 00
•