22 AP.PLICATIO���N...... FOR HOUSE MOVING PERMIT
' iI,Of OF CUPERTINO
1959 ,�-rl �
Date195_f Permit No.��
CIT / VI CUPER IN
Fee I
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
indicated in accordance with Ordnance No. of the City of Cupertino.
Owner �- -
By4 Approved_
C Nl'RA OR, AGr:NT BUILDING INSPECTOR
Building contstructed ofNo. of Rooms
MATERIALS Width gae4
Height�_�_(c—'
Condition of exterior
Condition of interior,
Present location / 7
Na. Street Lot Block ,/ Tract City
Proposed location-��I r
No. Street Lot Bloc 0 y City
Site location on new lot
,tt
42
Route on which builoe,is to be move
Tax certificate Ownership certificate filed Fee Deposited
Other information