CHANGE OF ADDRESS Building Department
CITY OF CUPERTINO
CUPERTINO 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
TELEPHONE:(408)777-3228 • FAX: (408)777-3333
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: June 30, 2009
• RE: Address Change APN 4357-14-008
Please note the following address change: 21885 McClellan Rd will remain for the main house.
The 2nd unit will be 21887 McClellan Rd. Please update your records accordingly. See attached
map.
The new address will take effect 30 days from the date of this letter. If you have any questions,
please call me at (408) 777-3246.
Sincerely,
Susan Winslow
Administrative Clerk
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- ✓ llClvhlg0�/�d� m Community Development Department
/// ! /'1 City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
Fax: (408)777-3333
CHANGE OF ADDRESS/ADD SUITE NUMBERS
REQUEST FORM
NAME (please print): Nl/ClN�4gZ ti1�C!-/ LIE WA&Iq
TELEPHONE NUMBER: (0( W) 72,&-OP Ce) (Slop) 4cPj?-3d'&
APN (assessors parcel ft A/37��� - 00oo -Oo
EXISTING ADDRESS: 2/y S C Cl�'��Qti� �G�., 04,Peyhka, cA 9-&i9
NEW ADDRESS REQUESTED:
NEW REQUESTED. 21 AP Vc C(e/lan led., 7jwz
Request for address change will be approved only if the change meets the following
criteria: /QCMQp� = Z(� ho►re lt�cCf/(-
• 1. The change of address will not create confusion.-- Ae V Coro' tlAt 00kf,,
2. Only the LAST DIGIT will be considered.
3. The odd/even addressing system will be maintained. JAI W'fd 44 ;Z� 1� r.,-
Setffje Mgti./ ( ft,
4. Suite numbers must be NUMERIC. &UirjH�p?,�-� PN t7✓66A
5. The change of address will not result in a public safety hazard_., s )XCXi PGA& jW-vu
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.
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CITY OF CUPERTINO
. RECEIPT NUMBER: BS000008007
RECEIVED BY: SUEW PAYOR: MICHAEL WANG
TODAY' S DATE: 06/22/09 REGISTER DATE: 06/22/09
TIME: 08 :38
1
ADDRESS CHANGE REQ NEW ADDR 2ND UNIT $306 . 00
'---------------
TOTAL DUE: $306 . 00
CHECK $306 . 00 REF NUM: 3463
TENDERED CHANGE
$306 . 00 $. 00