175 — /7- 4e5
A ILIL CATIONTF�OR HOUSE MOVING PERMIT
f� C11IT,Yi.OF CUPERTINO
1MAY 18 1965
Date— Permit No.Z
til I r Or WrLn i niv Fee $ S200
M' Application is hereby made to the City of Cupertino for a permit to move the building
N,, described on the reverse side hereof from and to the specified location at the time and date
indicated in accordance with Ordnance No. of the City of Cupertino.
Owner
J
B �7�'�
y7_ Approve
� CONTRACTOR, AGENT BUILDING INSPECTOR
Phone .5. —K J l'
Building contstructed of,7�.>__ Y No. of Rooms_
MATERIALS Width
Height
Condition of exterior,�f«�e�
Condition of interior pp
Present location
No. Street G Lot Block Tract City
Proposed location A0 O
0
No. Street Lot Block Tract City
Site location on new lot
Route on which building is to be moved
i
Tax certificate filed Ownership certificate filed Fee Deposited
Other information