Address Letter ste 229A
CITY OF
CUPEI�TINO
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
FAX: (408) 777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: June 22, 2004
so RE: Address Change (APN #326-34-074)
Please note the following address change: 10001 N. De Anza Blvd has added suite
number 229. Please change 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
LA
Printed on Recycled Paper
P• 1 of 1
RECEIPT # : 26001
RECEIPT DATE : 06/21/2004
CslwwdKilaw0lidoNvMlvLd
MISCELLANEOUS RECEIPT
PRINT DATE 06/21/2004
PRINT TIME 14:37:07
OPERATOR counter
COPY # 2
RECEIVED BY counter CASH DRAWER: BS1
RECD. FROM SHP MGMT ITF 500 FOR
USER 1
USER 2
NOTES : CHG ADDRESS FOR 10001 N. DE ANZA BLVD/ ADD SUITE #229
FEE ID AMOUNT
ZADDCHG 245.00
TOTALS: 245.00
'-IOD OF PAYMENT AMOUNT
CHECK 245.00
TOTAL RECEIPT : 245.00
•
THIS RCPT BALANCE
245.00 0.00
-------- --------
245.00 0.00
NUMBER
------------------
002416
CITY OF
CUPEI�TINO
11
0
NAME (please print):
TELEPHONE NUMBER:
Community Development Department
City of Cupertino
10300 Torre Avenue 11501 Li ^
Telephone: (408) 777-3228 '3a r,
Fax: (408) 777-3333
CHANGE OF ADDRESS
REQUEST FORM ` ( Pro�
T ... /-,,a //i i) i t l A Corn P'Ln,
(,6o 3L4 L4 - 15 oso
APN: 1 32�--zq—O 7'�4— 0O
EXISTING ADDRESS:
I ctT-o I P. DeAn-2,cA 91
NEW ADDRESS REQUESTED:
su4e, Vluml') l 22�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. The change of address will not result in a public safety hazard.
5. PROOF OF OWNERSHIP IS REQUIRED. (Ex. property tax bill)
The fee for a change of address request is $245.00. 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 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.
Signature
Revised 10/16/02
Printed on Recycled Paper
Ir7l�
Date