133 APPLICATION FOR HOUSE MOVING PERMIT
® �CIT�OF CUPERTINO
�� IIIIll I
Date I9f— Permit No.
CITY OF CUPERT Fee $_ga -0
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.
Owne l �IQ 61
'(By ' Approved
ro
h C��O//NTRACTOR,/ENT BUILDING INSPECTOR
Building contstructed of OJ LSC Cd Q� No. of Rooms
MATEJ! LS Width
Height_
Condition of exterior `
Condition of interior
Present location
No. Street Lot�DBloc k Tract City
Proposed locatioZcl5
No. 'F,SrtcreeL Lot_r &lock f Tract rCjty
Site location o o newnew t I5f
S T- " F yv — $ 7la �4o
��qq €
A lRoute
on which building is to be moved &drn 'le —IV 741
T !6Y'
Io — �e r —W tm— iv a
Tax certificate led Own�t�J Tp9 c filed ee De d
y S'�`os
Other information "'2 '3 v R�—