Change of Address City of Cupertino
• 10300 Torre Avenue
CM-OF Cupertino,CA 95014-3255
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: April 06, 2006
• RE: Address Change (APN #357-17-010)
Please note the following address change: 21646 Stevens Creek Blvd. has been divided
into two offices. 21646 Stevens Creek will remain the same. The new office has been
assigned 21648 Stevens Creek Blvd. ( See attached map). Please update your records
accordingly.
The new address will take immediately. If you have any questions, please call me at
(408) 777-3246.
Sincerely,
Susan Winslow
Administrative clerk
•
Printed on Recycled Paper
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EMecUr Roe Y.aW5-1006
Community Development Department
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
OFax: (408)777-3333
CHANGE OF ADDRESS/ADD SUITE NUMBERS
REQUEST FORM
NAME (please print): 1 \�Y� cti r�t \1 C -Yr s V-a
TELEPHONE NUMBER: (�22���j Q) Z F —576 -�3 r
APN (assessors parcel #):
EXISTING ADDRESS:. V0 vin,-('r��;K Gil yl)-
NEW ADDRESS REQUESTED: 2 1
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. (Ex. 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
• ap royal.
Signature Date
City of Cupertino
Annotation
Abc Street Names
c Address
CityBoundary r -
- Street Centerline
Right-of-Way ,P .
❑ Parcels ; ,
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SCALE 1 : 1.380
100 0 100 200 300
FEET
•
http://aguardsrvr/cupertinoassessor/home/maps/CupertinoAssessor.mwf Thursday, April 06, 2006 10:35 AM
CITY OF CUPERTINO
1 Of 1 MISCELLANEOUS RECEIPT
RECEIPT # 33561 PRINT DATE :03/14/2006
PRINT TIME 14 :04 :50
RECEIPT DATE 03/14/2006 OPERATOR suem .
COPY # : 2
RECEIVED BY suem CASH DRAWER: BSI
RECD. FROM CHRISTEANNA WONG
USER 1
USER 2
NOTES
FEE ID AMOUNT THIS RCPT BALANCE
________ ________ _________ ________
ZADDCHG 268.00 268 .00 0.00
TOTALS: 268.00 268 .00 0.00
METHOD OF PAYMENT AMOUNT NUMBER
CHECK 268.00 816
7� RECEIPT 268.00
.-4 .� .-. --- DETACH HERE .... _ _ -�--r, "-^-- - •,.utlncnnenc-- -- _ - ._..,-_
PARIVASH MIN00 , 2002-2003 TAXING aOR1cT. 1az RArE
17 MAXIMUM TAX. LEVY 1 . 000001
1174 BUBB RD'T-,--- SUPPLEMENTAL PROPERTY'TAX BILL- CO RETIREMENT LEVY 03880_'
{t � UPERTINO CA ' r� �. . ..9,5014 -; •„C_OUNTYOFSANTACCARApSTATEOF.CALIFORNIA',- CO LIBRARY RETIREMENT e,''«,, . .00240
.rteFISCALYEARJULY,•1,2002TOJUNE 30,,2003 ” ELEM' OR UNIF BONDS-
•� ..03290
" ' HIGH SCHOOL BONDS- . 03540'
TAX COLLECTOR,SANTA CLARA COUNTY �. TOT ASSESSED' VAL•.RATE �.1 .10950 ,
' COUNT4GOVFRNMENTCENTER EAST WING SCVWD-STATE WATER PROJ 00630,
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, 00090fPAOPATY ADDRESS 70.W HEDDING STSAN JOSE CA 95110 1767 SCVWD-ZONE W-1 BOND.
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CUPERTINII «x95014"
rTAX RATE AREa PARCEL NUMBER `
TRANSACTION DATE OCT 11,2 0 0 2
j - j 13-027 357. 17,,,;010-21'_1
JUN 0.4;,2003 I1
BILLING Akar
,
FCV 2002/2003 NEW BASE-.,;---
FDOCUMENTPNO . 6533049 'LAND - 32050 - 504000 471950 ,!�
I - y `IMPS 29547 '150000 's120453 �
PHIS- SUPPLEMENTAL BILL'- IS IN. PP '. = ,,, '
1DDITION.TO THE ANNUAL-SECURED - TFCV 161597 654000 -592403 - -THIS SUPPLEMENTAL BILL IS IN ADDITION
BILL. ' THIS BILL_HAS NOT, BEEN SENT HOEX .-.TO THE ANNUAL SECURED BILL. THIS BILL
f0 YOUR :LENDER CONTACT+Y.OUR. �+ -; _ '�EXEM ,. -"`• ,_,�,"• ' - • °-HAS NOT BEEN SENT TO.YOUR-LENDER.', 1
LENDER" IMMEDIATELY IF YOU WANT "'TOT. 61597 1654000 592403° CONTACT .YOUR LENDER IMMEDIATELY: IF,,;
THEM TO PAY. _ • - -*TOTAL •DIFF.ERENCE ,OF 592403 X 67 .00/• . ,
•FACTOR =, 396910 WHICH PRORATES' TAX•- -YOU_WANT THEM TOPAY.
_
FROM TRANSACTION DATE TO JUN 30,20133'. t
OESCRIPTIONy.~ :: -FULLCASH VALUE'-!q rxTAX RATE PER.5100 -' TAX'AMDUIJTS +:''$' 1421• 06/U5/D,3 21 - - °
! AND 1'st INSTALLMENT' 2nd INSTALLMENT, '
_316,206 `•} t ;r
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IMPROVEMENTS ` 1•80,703 - - 10%PENALTY.ADDED '109!6,PENALTY 1 $10 COST ADDEO
TOTAL LAND a1MPROVEMENTS `-"396,909 '.00720 •' `.r~ 28 -56 AFTER' JUL 31,2003 AFTER NOV 30,2003. - -
PERSONAL PROPERTY T-.; ' +
TOrALEuucasH�AwE _�` � 1396 9,09 , .1 .10950. ., 4,403.70 TAx --: $2,216 1 $Z 216:13 '..54 432:26
I;SPECIAL ASSE$$1MENi$ y- .101 PENALTY - t •^ ! .(� , 1
caoss TAX *� - ? 4,432t26 COST s-
LEER HONIEOP^1ER'SEXEMPT 1ON `tl ,t`q:' ?_'.0 SECTION SIE _ -
'OTHERnEMPTION^ - - RET!CK'r CHG. . - - .I
- . DOTAL TAXES; ., $4 432:26 TOTAL---. {
5•.
L FOR,U.S:-MAIL PAYMENTS THE U;S POSTMARK IS'USED AS THE DATE PAYMENT.IS`RECEIVED,BY THE TAX COLLECTOR,BE"SURE YOUR PAYMENT IS'
I MAILED EARLY ENOUGH TO BE PROCESSED BY.THE U.S. POSTAL SERVICE WITH A POSTMARK,NOT LATERTHAN THE'DELINQUE IT DATE 1
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SEE REVERSE
INSTRUCTIONS PAYMENT NSTINSTALLMENT Z
Ana( n J � ( '
2005 2006 DUE FEB. 1 2iOO6 _ S4„459:85 ( GC�(.mlJ
357-17-010-00 PENALTY'AFCER AP�2 10,, 2006
54 i TO PAY BOTH INSTALLMENTS
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PARIVASH MIN00 492583 E �
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