NO PERMIT NUMBER (2) 300 ofCupertino
Avenue
.t 10300 Torre Avenue
�.. Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF FAX: (408)777-3333
CUPEkTINO
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: May 24, 2007
RE: Address Change APN #356-08-022
• Please note the following address change: 22164 McClellan Rd is changing their
address to 22168 McClellan Rd, Cupertino, CA. See the attached map. Please update
your records accordingly.
The new address will take effect immediately. If you have any questions, please call me
at (408) 777-3246.
Sincerely,
Ad47f—)
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
NAME (please print): 6ordm Lev
TELEPHONE NUMBER: 4U$- 252 3538
APN (assessors parcel #): 356 -UB- 022-*
EXISTING ADDRESS: 221bq M&Clallan RoadL CuPerh'no, G�3 g5blq
NEW ADDRESS REQUESTED: 22165 MCiC Jan Road Cupc✓h-no Gq q-,ZI4
NEW SUITE NUMBERS REQUESTED:
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
approv .
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U H F ¢
' CITY OF CUPERTINO
RECEIPT NUMBER: BS000001135
RECEIVED BY: PATRICIAG PAYOR: PEGGY & GORDON LEE
TODAY'S DATE: 04/27/07 REGISTER DATE: 04/27/07
TIME: 14 : 52
1
ADDRESS CHANGE 22168 MCCLELLAN RD $268. 00
----------------
TOTAL DUE: $268. 00
CHECK $268. 00 REF NUM: CK #2434
TENDERED CHANGE
$268 . 00 $ . 00
•
I •