CHANGE OF ADDRESS, SUITE #170 & 172 City of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
CITY Of Telephone: (408)777-3228
CO P E IST I NO 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 #369-40-016)
• Please note the following address change: 20380 Town Center Lane has added suite
numbers 170 and 172. 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
CITY OF CUPERTINO
We 1 of 1 MISCELLANEOUS RECEIPT
RECEIPT # 25998 PRINT DATE 06/21/2004
PRINT TIME 14 : 06 : 58
RECEIPT DATE 06/21/2004 OPERATOR counter
COPY # 2
RECEIVED BY counter CASH DRAWER: BS1
REC ' D. FROM CTC FUNDING, LLC
USER 1
USER 2
NOTES : CHG ADDRESS FOR 20380 TOWN CENTER LANE #170 / ADD 4172
FEE ID AMOUNT THIS. ,RCPT BALANCE
ZADDCHG 2.45 . 00 245 . 00 0 . 00
-------- -------- --------
TOTALS : 245 . 00. 245 . 00 0 . 00
0THOD OF PAYMENT AMOUNT NUMBER
- - - - - - - - --- ---- ----`-- - ----------
C CK 245 . 00 102601
TOTAL RECEIPT 245 . 00
•
CITY OF CUPERTINO
Oge 1 of 1 MISCELLANEOUS RECEIPT
RECEIPT # 25998 PRINT DATE : 06/21/2004
PRINT TIME : 14 : 06 : 59
RECEIPT DATE 06/21/2004 OPERATOR : counter
COPY # : 3
RECEIVED BY counter CASH DRAWER: BSI
RECD. FROM CTC FUNDING, LLC
USER I
USER 2
NOTES : CHG ADDRESS FOR 20380 TOWN CENTER LANE 4170 / ADD 4172
FEE ID AMOUNT THIS RCPT BALANCE
ZADDCHG 245 . 00 245 . 00 0 . 00
TOTALS : 245 . 00 245 . 00 0 . 00
THOD OF PAYMENT - AMOUNT NUMBER
-------- - - - --- --
CK 245 . 00 102601
TOTAL RECEIPT 245 . 00
•
Community Development Department
City of Cupertino
10300 Torre Avenue
2 Q Telephone: (406)777-3228
Fax: (406)777,3333
CITY F
CUPEkTINO
CHANGE OF ADDRESS
REQUEST FORM
NAME(please print): : 1'` FJ ! t G
1
TELEPHONE NUMBER:
APN: (�
EXISTING ADDRESS: A r I,7
NEW ADDRESS 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. 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 Date
• Revised 70/16/02
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.(70) _ CHECK DATE: 06/14/04 CHECK NO. : 102601
Invoice No. Inv. Date Amount Discount Description" `Voucher No. Net Amount
06 245:00 06/14/04 —245.000.00 /�''_^��CHange-of Add[ess_A102 ��^y1 02509.^-. �^^-� 245.00.'
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TOTAL 245.00 0.00 245"00