NO PERMIT NUMBERCITY OF
CUPEkTINO
•
-•
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
FAX: (408) 777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: June 22, 2004
RE: Address Change (APN 369-02-031)
Please note the following address change: 20230 Stevens Creek Blvd. has added suite
number "E". They already have existing suite numbers A, B, C, & D. Please change
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
1 of 1
RECEIPT # : 25997
RECEIPT DATE : 06/21/2004
CITY OF CUPERTINO
MISCELLANEOUS RECEIPT
RECEIVED BY counter
RECD. FROM TORRE AVENUE PROERTI
USER 1
USER 2
PRINT DATE 06/21/2004
PRINT TIME 14:01:42
OPERATOR counter
COPY # 3
CASH DRAWER: BSI
NOTES : CHG ADDRESS FOR 20230 STEVENS CREEK BLVD, ADD SUITE #E
FEE ID AMOUNT _THIS RCPT BALANCE
ZADDCHG 245.00 245.00 0.00
-------- -------- --------
TOTALS: 245.00 245.00 0.00
HOD OF PAYMENT AMOUNT NUMBER
---- --------
CHECK 245.00 10503
TOTAL RECEIPT 245.00
06/18/2004 07:40 FAX 408 777 3333 CITY CUPERTINO 160011001
Community Development Department
City of Cupertino
103011 Tone Avenue
Telephone: (408) 777-3228
Fax: (408)777-3333
I
CUPEkTIN4
CHANGE OF ADDRESS
REQUEST FORM
NAME (please print):
TELEPHONE NUMBER: SFS- 3
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APN: 3�P�1
EXISTING ADDRESS: , °'ba 51C�V�6CJlQ o QKVZ� l Cly ,CSR
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NEW ADDRESS REQUESTED: w F AY dC@l fl. 0 �tM }� r 46 O v--✓
W Q C unn4F lbw e Su k, (� a C9
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 direct costs 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 address will be in effect thirty (30) days following approval.
Signature
Revised 10/16/02
Pdnled on Roeyded Poor
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