30APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
Date 191E Permit No. A o
Fee $
Application is hereby made to the City of Cupertino for a permit to move the building
described on the reverse side hereof from and to the specified location at the time and date
indicated in cordance with Ordnance No. f; he CI -V of Cu erti
Owner
t
I y Approved-
CONTRACTOR, AGENT BUILDING INSPECTOR
Phone -: L.. a- - ..
Building contstructed of )44—d—aL No. of Rooms
0 MATERIALS Width /0
Height
Condition of exterior.
Condition of intern
Present location-/—
Proposed
ocationProposed locatior/
Site location on new
Street,' Lot n Illock Tract City
&-d n .
Street Lot Block Tract City
on which buildine is to be
Tax certificate filed Ownership certificate filed Pee Deposited
Other