102 APPLICATION iFOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
'( JUN 3
Date v 19 Permit No.
CITY. OF CUPERTNO 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
U. indicated in accordance with Ord anm No. r, of the City of Cupertino.
Owner
v
Y - t
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By Approved
v: CONT0.ACT0¢JAGENT BUILDING INSPECTOR
yq Phone V ..... '
Building contstructed of , c No. of Rooms
MATERIALS Width
Height 1,7
Condition of exterior
Condition of interior ��,, � �—
Present location ��g 006/ , - I
No. Street Lot Block Tract City
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Proposed location
No. Street Lot//'
ot Block Tract Ci
Site location on new lot
Route onwhich building isto be
moved
r
Tax certificate filed Ownership certificate filed Fee.Deposited
Other information