NO PERMIT NUMBER (3) City of Cupertino
10300 Torre Avenue
Cupertino,CA 95019-3255
Telephone: (908)777-3228
CIT'OF FAX: (408)777-3333
CUPEI�TINO
BUILDING DEPARTMENT
OFFICIAL.NOTIFICATION OF ADDRESS CHANGE
TO: All Agencies
FROM: City of Cupertino
DATE: January 24, 2007
RE: Address Change APN #357-16-011
• Please note the following address change: 21796 Stevens Creek Blvd.'s address has
changed. The new address is 10015 Orange Avenue. Please update your records
accordingly.
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
Printed on Recycled Paper
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BYRNE
TRACT No 6574 TRACT No 6717
PATRICIAN TOWNHOUSES
•
Community Development Department .
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
• Fax: (408)777-3333
CHANGE OF AVDRESS/ADD SUITE NUMBERS
CREQUEST FORM
NAME (please print): CU-6
TELEPHONE NUMBER: L109 Wi S /-9, 2
9
APN (assessors parcel
EXISTING ADDRESS: !� 1� hllJ � �� S C W V
NEW ADDRESS REQUESTED: . V r el�1 Ci E OL y E
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. (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 gr ted, the new address will be in effect thirty (30) days following
approval.
i0-I )J\MD
Signature Date
CITY OF CUPERTINO
1 of 1 MISCELLANEOUS RECEIPT
RECEIPT # : 37021 PRINT DATE : 12/12/2006
PRINT TIME : 14 : 50 : 03
RECEIPT DATE : 12/12/2006 OPERATOR : amyw
COPY # : 3
RECEIVED BY : amyw CASH DRAWER: BS1
RECD. FROM : AIDA CUKIC
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 AMOUNTNUMBER
------ ----------- ------------ -------- ----
CHECK 268 . 00 2413
•AL RECEIPT 268 . 00
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