ADDRESS CHANGE - 160 City of Cupertino
+• �-I 10300 Torre Avenue
Cupertino,CA 95014-3255
CITY OF
Telephone: (408)777-3228
CUPEI�TINO FAX: (408)777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: March 20, 2008
RE: Address Change APN # 366-10-131,132,133,134
• Please note the following address change: 1601 S De Anza Blvd, is adding suite#160.
Please update your records accordingly.
The new address will take effect 30 days from the date of this letter. If you have any
questions, please call me at (408) 777-3203.
Sincerely,
SYLVIA MENDEZ
Senior Office Assistant
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Printed on Recycled Paper
03,-'20/2009 13: 12 FAX 408 777 3333 CITY CUPERTINO fa 002/002
Community Development Department
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
CHANGE OF ADDRESS/ADD SUITE NUMBERS
n/r11REQUEST FORMr
NAME(please print): p� n�lrr�r�"
TELEPHONE NUMBER: rbw S o — V 010 t I (09
APN (assessors parcel 132 r ( 33 /
EXISTING ADDRESS: �Od( S �►�ZO� V1U� (��
NEW ADDRESS REQUESTED I (O U S• kI Ind ?"Al. 1 Q (P
NEW SUITE NUMBERS REQUESTED: t'I d(P
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
$306.00 (per hour). 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.
ORAAa� 3��/ 09
Signature vU Date
CITY OF CUPERTINO
RECEIPT NUMBER: BS000004222
RECEIVED BY: SYLVIAM PAYOR: DOLLINGER PROP.MGMT
TODAY'S DATE: 03/20/08 REGISTER DATE: 03/20/08
TIME: 15 : 57
1
ADDRESS CHANGE 1601 S DE ANZA # 106 $306 . 00
----------------
TOTAL DUE: $306 . 00
CHECK $306 . 00 REF NUM: 19877
TENDERED CHANGE
$306 . 00 $ . 00
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