CHANGE OF ADDRESS a' a
City of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
CITY QF 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: May 07, 2004
RE: Address Change (APN #316-03-039)
• Please note the following address change: 19940 Homestead Road has been divided
into three units. The new addresses are 19940 Homestead Road, Suit #100, 200, and 300.
Please change your records accordingly.
The new addresses will take effect thirty days from the date of this letter. If you have
any questions, please call me at (408) 777-3246.
Sincerely,
Susan Winslow
Administrative clerk
•
Printed on Recycled Paper
CITY OF CUPERTINO
F• 1 of 1 MISCELLANEOUS RECEIPT
RECEIPT # : 25290 PRINT DATE : 04/23/2004
PRINT TIME : 14 : 13 : 09
RECEIPT DATE : 04/23/2004 OPERATOR : counter
COPY # : 3
RECEIVED BY counter CASH DRAWER: BS1
RECD. FROM SOUTH VALLEY PROPERT
USER 1
USER 2
NOTES : WAYNE GONG 19940 HOMESTEAD 4100 , 200 , 300
FEE ID AMOUNT THIS RCPT BALANCE
_ _
ZADDCHG 245 . 00 245 . 00 0 . 00
-------- -------- --------
TOTALS : 245 . 00 245 . 00 0 . 00
METHOD OF PAYMENT . AMOUNT NUMBER
�CK 245 . 00 3819
TOTAL RECEIPT 245 . 00
•
i Community Development Department
k" City of Cupertino
1 10300 Torre Avenue
Telephone: 408 777-3228
Fax: (408) 777-3333
CITY OF
?UPEkTINO
CHANGE OF ADDRESS
REQUEST FORM
NAME (please print): V2Z
TELEPHONE NUMBER: �o b ' 2
APN: ?J - Q
EXISTING ADDRESS: 1— c�iUl oLa c� I ln-"fz) 3 Uv1 S
NEW ADDRESS REQUESTED: 3b, -c-- �dyi �}e 2�7y� 7+C
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 direc�sts-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 ad ess will be in effect thirty (30) days following approval.
gna re Date
•
Revised 10/16/02
Printed an Recycled Paper
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