1350,
PAPA PL'ICATIOWFOR-)HOUSE MOVING PERMIT
`p A lif
jEC 18 jgbQTY OF CUPERTINO
Date 1� f 1 ID�177'i� 3 Permit No.
Fee
Application is hereby made to the City of Cupertino for a permit to move the building
described on the reverse side hereof from a to the specified location at the time and date
indicated in accordance with Ordnance No of the City of Cupertino.
Phone
CONTRACTOR, AGENT
Approved
' BUILDING INSPECTOR
Building contstructed
Condition of
Condition.of
Present locate
Proposed location/—
Site location on new
O
MATERIALS
No. Street Lot
No. - Street Lot
is to be moved,. o
Tax certificate filed Ownership
Other information
No. of Rooms
Width 2
Height / 7
Block Tact City `
Block Tract City O
�UC�rs crc/G �d ,
to filed Fee Deposited