NO PERMIT NUMBER 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: November 23, 2010
RE: Address Change APN#369-38-014
Please note the following address change: 20294 Silverado Ave, Cupertino is being changed to
20298 Silverado Ave, Cupertino. 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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Building Department
CITY OF CUPERTINO
10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
TELEPHONE:(408)777-3228 • FAX: (408)777-3333
CUPERTINO
CHANGE OF ADDRESS/ADD SUITE NUMBERS
nn 11-- REQUEST FORM
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NAME (please print): U 4Q& PC
TELEPHONE NUMBER: AL 310 6—b-o 6
APN (assessor's parcel
EXISTING ADDRESS: �(��Q�{ �� y&&dn Ai)-e. (_ fip:e fib C 7>61T
NEW ADDRESS REQUESTED:�fl�gR S ytlAdb AK , P.(,'& w CAP
NEW SUITE NUMBERS REQUESTED: N !/A
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. A reduced-scale copy (81/2 x 11 or 11 x17) of a site plan which shows addresses on each side of
the building site, along with the closest address across the street from the entrance of the
building. If there are unit or suite numbers,show the layout of the units and have all
unit/suite numbers on the site plan.
7. PROOF OF OWNERSHIP IS REQUIRED. (property tax bill+ otf4u b S Lt
The fee for a change of address/addition of suite numbers request is$317. 0 (per hour). The fee is
due with this request form and will not be refunded if the request is deniR n /
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.
Sign re Date
CITY OF CUPERTINO
RECEIPT NUMBER: ES000012001
RECEIVED BY: PAT PAYOR: CHEN HWA PAI
TODAY'S DATE: 11/15/10 REGISTER DATE: 11/15/10
TIME: 10 : 58
1
ADDRESS CHANGE 1 .000 @ $317.00 $317 . 00
----------------
TOTAL DUE: $317 . 00
CHECK $317. 00 REF NUM: #4976
TENDERED CHANGE
$317. 00 $ . 00
Print Date: October 19, 2010 11:23 AM Page 1
A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN OMB No. 2502-0265
III�II SETTLEMENT STATEMENT 1. [ ] FHA 2. [ ] RHS 3. [X ] Conv. Unins
d a FINAL STATEMENT 4. [ ]VA S. [ ]Conv. Ins
O Chicago Title Company 6. FILE NUMBER: 7. LOAN NUMBER:
10-98418828-WM 1101037885
8. MORTGAGE INSURANCE CASE NUMBER:
C. Note: NOTE: THIS FORM IS FURNISHED TO GIVE YOU A STATEMENTOF THE ACTUAL SETTLEMENTCOSTS. AMOUNTS PAID TO AND BVTHE SETTLEMENT AGENTARE SHOWN.ITEM�
MARKED"(P.O.C.)"WERE PAID OUTSIDE OF THE CLOSING: THEY ARE SHOWN HERE FOR INFORMATIONAL PURPOSES AND ARE NOT INCLUDED IN THE TOTALS.
D.NAME&ADDRESS OF BORROWER: E. NAME&ADDRESS OF SELLER: F.NAME&ADDRESS OF LENDER:
Chen-Hwa Pai Sze K. Ho MD Inc., Employees Pension Plan and Pinnacle Capital Mortgage Corporation
20294 Silverado Drive Trust 1390 Willow Pass Road,Suite 560
Cupertino,CA 95014 500 40th Street Concord,CA 94520
Bakersfield,CA 93301
G. PROPERTY LOCATION: H.SETTLEMENT AGENT. I.SETTLEMENT DATE:
20294 Silverado Drive Chicago Title Company October 19, 2010
Cupertino,California 95014 408 253-9050
PUCE OF SUMEMENT: FUNDING DATE:
20100 Stevens Creek Blvd, Suite 100 October 18, 2010
Cupertino,CA 95014 DISBURSEMENT DATE:
October 19,2010
J.SUMy�yMyARY.YOF BORROWER 5 TRANSACTIO yNyK SUEEM�MARYOFSiE�LjERS TR4NSAC777ON
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101.Contract Sales Price 1,062,750.00 401.Contract Sales Price
102. Personal Property 402. Personal Property
103.Settlement charges to borrower(line 1400) 14,050.80 403,
1G4• 404.
105, 405.
Adjustments for Items Paid by Seller In Advance Adjustments for Items Paid by Seller In Advance
106.City/Town Taxes - 406.City/Town Taxes
107.County Taxes •j [) - j. 407.County Taxes
108.Assessments AND T 0,f D , 408.Assessments
109. 409.
110. 410.
111.
112. 412.
113. 413.
114. 414.
115. 415.
116. 416.
117. 417.
118, 418.
120.GROSS AMOUNT DUE FROM BORROWER 1,076,800.80 420.GROSS AMOUNT DUE TO SELLER
,"; ' 1.1;, < r '. `liE ';:.> t#� sMr;.'.!?] P. G4 . " .. ! a
201. Deposit or earnest money 716,884.22 501. Excess deposit(see Instructions)
202. Principal amount of new loan(s) 350,000.00 502.Settlement charges to seller(line 1400)
203. Existing loan(s)taken subject to 503. Existing loan(s)taken subject to
204.Offset escrow fee 1,100.00 504.
205, Offset Owner title prem 2,454.00 505.
206.Offset transfer tax 1,169.30 506.
207. NRCC from Broker 21712.95 507.
208• 508.
209. 509.
Adjustments for Items Unpaid by Seller Adjustments for Items Unpaid by Seller
210.Cityrrown Taxes 510.City/Town Taxes
211. UnPd County Taxes fir 7/1/2010 to 10/19/2010 3,098.40 511.County Taxes
212.Assessments 512.Assessments
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220.TOTAL PAID BY/FOR BORROWER 1,077,418.87 520.TOTAL REDUCTION AMOUNT DUE SELLER
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301.Gross amount due from borrower(line 120) 1,076,800.80 601.Gross amount due to seller(line 420)
302. Less amounts paid by/for borrower(line 220) 1,077,418.87 602. Less reductions in amount due seller(line 520)
303.CASH (FROM)(XX TO) BORROWER 618.07 603.CASH(TO) (FROM)SELLER
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