128APPLIC.ATION-(FOR HOUSE MOVING PERMIT
T11,110V
� Q ITY� RO,F CUPERTINO
15 9963 E,
Date , 195— Permit No.
CITY OF CUPEPIXU'Fee $ ,Zq O m_
Application is hereby made to the City of Cupertino for a permit to move the building
described on the reverse side hereof from anV- the specified location at the time and date
indicated in accordance with Ordnance No. of the City of Cupertino.
Owners^�
$y '� � Approve
CONTRACTO , AGENT BUILDING INSPECTOR
AG
J / Building contstructed of
MATERIALS
/OF
F'
ki
Condition of exterior
Condition of interior C-0
Present location /e, 917
Street Lot Block
No. of
City
Proposed location /C Q�A�
No. Street Lot �Block Tract City
Sito,locatioMn noW.lot -,2 we) / %C� 0- /, _ 2�J41 Oki / 0"iciX-"4
is to be