181 7 6 5-
i
APPLICATION FOR HOUSE MOVING PERMIT
CC ISI, OF CUPERTINO
fcd�
1 1965 +
Date?- 95— Permit No._/-&-/
CITY u CUPERTINO pee $�o
Application is hereby made to the City of Cupertino for a permit to move the building
M described on the reverse side hereof from and to the specified location at the time and date
indicated in accordance with Ordnance No.g2,of the City of Cupertino.
N I
Owner�� 2 ,/
16
u By —�f.��t � APProve
CONTRACTOR, AGENT BUILDING INSPECTOR
-- \
Building confstiucted of_, —d W No. of Rooms
MATERIALS Width
Height
Condition of exterior
Condition of interior_
Present location/4917/ „_I
No. / Street Lot Block Tract City
2,0/03CaPoc�rG'
Proposed location
No. Street Lot Block Tract City
SiteO location on new lot
Route on which building is to be to be mo� �
Tax certificate filed Ownership certificate filed Fee Deposited
Other information