110 P�PTfOR HOUSE MOVING PERMIT
OF CUPERTINO
eiJqL 2 9868
Dat 1w— Permit No. 'o
CI OF CUPERTINO 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
X11; indicated in accordance with Ordnance No._of the City of Cupertino.
4
Owner /ssifl�,c a, F�4/vstcC�iutit.i ,� ��C .
N T
C
v By Approved�3a
CdVMAd
� yy CTDiy'AGHNl' 9UILDINO WSPHC70B
Phone .4�.pl..._'9Oao........_
Building contstructed of �114- t� No.of Rooms
MATERIALS Widrh_, .7
Condition of exterior
Condition of interior
Present location /02 rte I I �Z4�de1��
No. Street Lot Block Tract
Proposed locatio Gd0
No. treet Lot Block Tract tty
Site location on new lot
Route on which building is to be moved
Tax certificate filed Ownership certificate filed .Fee Deposite Q' od
Other information . -71,116,3
0 69�
• TO DEPARTMENT
t RECEIPT •
• CITY OF CU PIER'][INO •
COLLECTORS OFFICE
• No.00.7694/ •
ATE 'j/i9 6j
• RECEIV •
FROM
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• AdDkES�CG l�i., u�c s rs�' _�-- •
• CASM I ENECN .-MONEY I •
ONEY pOLLAN9 CENTS
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