109 V��t'PPLICATION)F01R HOUSE MOVING PERMIT
JUN 27 196 I�� CUPERTINO
Date Y—'MI F T! 95_ Permit No. U
Fee$ .1 of
M\\ 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 scJ
v T
By � Approved
CONTRACTORS AGENT BUILDING INSPECTOR
7\ PhoneC�-.f...-.z.�...�2...�1.......
Building contstructed of No. of Rooms
MATERIALS Width ;7,,S—
Height
Condition of exterior �F� c//=��i"
Condition of interior Gda Cry
Present location./n S/ 6 'NU-- -1
No.
N'� �
o. Street Lot Block Tract City
Proposed location 2 Y6 .SUf�ILI�/' �Z� .��OS e
No. L/Street Lot Block Tract City
Site location on new lot
Route on which building is to be moved_ _ S D (le vet/
Cd 7 a C S4't" jao5e _
Tax certificate filed Ownership certificate filed Fee-Deposited
Other information