1715- 14`a11 Q. l,.
APPLICATION FOR HOUSE MOVING PERMIT
J I[' GI OF CUPERTINO
tARE1`00 19665 - 5
Date 195_ Permit No.(71
CITY OF CUPE�TINO Fee
�{pplication is hereby ma a to the City of �Cpupertino for a permit to move the building
described on the reverse side hereof from a the specified location at the time and date
indicated in accordance h Ordnance No. �%�{� f the City of Cupertino.
Owner n( �i
., l�"=3'%�t�-/tel
CONTRACTOR, AGENT
Phone
BUILDING INSPECTOR
Building contstructed of t est a Y�Cev
MATERIALS
Condition of exterior
Condition of interior
Pre$ent location
No. St
Proposed location
Block-" ^Tract
No. of Rooms
Width
Height
No. Street(/`�ot Block Tract City
Site location on new lot Vl �, QaralgL�
Route on which building is to be
Tax certificate filed Ownership
Other information
!m
Deposited