NO PERMIT NUMBERC,
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bDFEB 1995
BLDG. INSPECTION DEPARTMENT
CITY OF CUPERTINO
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10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 252-4505
FAX: (408) 252-0753
COMMUNITY DEVELOPMENT
7W.T
NAME (please print):
PHONE NUNBER:
i
Cites of Cupertino
CHANGE OF ADDRESS
ii' t . .P.O. Box 580
-i', i1: r Cupertino, CA 95015-0580
EXISTING ADDRESS
NEW ADDRESS REQUESTED
Procedure for Reassigning Addresses:
Requests for reassignment of addresses will be approved if consistent with
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. The change in address will not result in a public safety problem.
5. Proof of ownership and picture identification is required.
The fee for change of address is $126.00. The fee is due with this request
form and will not be refunded if request is denied.
The direct costs associated with a request to change address will be borne
by the applicant. Approximate review time is fifteen (15) days. If change
of address !is granted, the new address will be in effect thirty days
following.
Signature
Date
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