ADDRESS CHANGE2 / City of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
CITY OF 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: September 07, 2007
RE: Address Change APN #369-07-001
• Please note the following address change: 10121 Miller Avenue has changed suite #202
to suite #200. 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,
Susan Winslow
Administrative Clerk
Printed on Recycled Paper
. 06-17-2007 10:20an Frcrtr T-461 P-002/002 F-777
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): _M,\.-x.
- TELEPHONE NUMBER: 2-f'08
APN (assessors parcel fl: o 9
MISTING ADDRESS:
NEW ADDRESS REQUESTED:
NEW SUITS NUMBERS REQUESTED: 3a0
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.
(3,Suite numbers must be NUMERIC.
S. The change of address will not result in a public safety hazard.
PROOF OP OWNERSHM I9 REQUIRED. (property tax bill)
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
e 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
Signature (/ Date
Ala
CITY OF CUPERTINO
RECEIPT NUMBER: BS000002537
• RECEIVED BY: SUEW PAYOR: HUNTER STORM
TODAY' S DATE: 09/04/07 REGISTER DATE: 09/04/07
TIME: 09 : 16
1
ADDRESS CHANGE ADD SUITE #200 $268 . 00
----------------
TOTAL DUE: $268 . 00
CHECK $268 . 00 REF NUM: 012401
TENDERED CHANGE
$268 . 00 $ . 00
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