Address Change-Add ste numbers® C OF
CUPEI�TINO
L1-
CA
City of Cupertino
10300'forre Avenue
Cupertino, CA 95014-3255
Telephone: (408)777-3228
FAX: (408) 777-3333
13UILDING DEPARTMENT
OFFICIAL NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: November 22, 2004
RE: Address Change (APN #369-41-005)
Please note the following address change: 10201 Torre Avenue has added suite
numbers 100, 200, 250, 300, and 350. 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
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.�AAAtAI glMo�11J i t 0l Community Developme, t Department
cit_ of Cupertino
�p 77 10300 Corre Avenue
Telephone; 408) 777-3223
• Fax: 408) 777-3333
CHANGE OF ADDRESS
REQUEST FORM
NANS (please print); C IQW--K%.a P't^oDPe^le — Lp
TELEPHONE NUivtB&R 4 -ng, $ S5= Ifo l0
MGMNG ADDRSSS: o 2, b l -Crr e A Ver► mez.
Request for address change will be approved only if the change meets the fol owing
criteria:
1. The change of address will not create confusion.
• 2 Only the LAST DIGIT wt'll be considered. JV IA
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3. The odd/even addressing system will be maintauted.
4. The change of address wM not result in a public safety hazard.
s. PROOF OF OWNERSHIP IS REQUIRED. (Ex. property tax bill)
The fee for a change of address request is $268.00. The fee is due -vrith this
requed form and wiH not be refunded if the request is denied
The direct costs associated with an address change request will be borne by tl to
applicant Approximate review time is fifteen (15) days. if the address change is
granted, t130aew address will be in effect thirty (30) days following approval
—44—ate
4Aged l0/16/02
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IS 1 of 1
RECEIPT # 27822
RECEIPT DATE 11/19/2004
CITY OF CUPERTINO
MISCELLANEOUS RECEIPT
PRINT DATE 11/19/2004
PRINT TIME 10:09:24
OPERATOR counter
COPY # 2
RECEIVED BY counter CASH DRAWER: BS1
REC'D. FROM PORTAL SOFTWARE
USER 1
USER 2
NOTES : ADD SUITES 1.00,200,250,300,350 10201 TORRE AVE .
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
-K ----------- --------268--.00 -- ---49795---------------
�
TOTAL RECEIPT 268.00