NO PERMIT NUMBER City or Cupertino
• ,� Torre Avenue
Cupertino,
CA 95014-3255
CITY OF Telephone: (408)777-3228
CU PE IST I NO FAX: (408)777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF NEW ADDRESS ASSIGNMENT
TO: All Agencies
FROM: City of Cupertino
DATE: January 24, 2007
RE: Address assignment
• Please note the following address assignment. Parcel 357-20-026 has added a new .
address. The existing address 10040 Bubb Rd will remain. The new address is 10050
Bubb Rd.,Suite numbers 1, 2, & 3, Cupertino, 95014. Please update your records
accordingly.
The new address will take effect immediately. If you have any questions, please call
me at (408) 777-3246.
LSincerely,
Susan Winslow
Administrative clerk
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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/L
NAME (please print): \ (, (�. n 7 �p n
TELEPHONE NUMBER: �C1
APN (assessors parcel #): 5/7- 21/��1oe?
EXISTING ADDRESS: ( 00 4-2 90L6
NEW ADDRESS REQUESTED: 100 ,4M &bh
NEW SUITE NUMBERS REQUESTED:(.UldPY 10O aLdid S'Lart Z, 2 . C d j
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. (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
approval.
Sig �we Date
Jac�i�
" CITY OF CUPERTINO
RECEIPT NUMBER: BS000000277
• RECEIVED BY: AMYW PAYOR: GREEN CIRCLE FOUND
TODAY'S DATE: 01/22/07 REGISTER DATE: 01/22/07
TIME: 09 : 59
1
ADDRESS CHANGE 10050 BUBB RD $268 . 00
----------------
TOTAL DUE: $268 . 00
CHECK $268. 00 REF NUM: 105
TENDERED CHANGE
$268. 00 $ . 00