12 APPLICATION FOR HOUSE MOVING PERMIT
4zaCITY Op CUPERTINO
A
Date ' .' j ^n ppermit No..���
Fee $
Ap�IITT)V/ rl� � IpERpT�Ap��
,1}cAflon tshereby�ma�lettblthF`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_
ByI OZo � Z":� ;V'Approved
Z J� eOl'BACT r IJ� _ B ", INSPECTOR
Building contstru ed of- d/Gv7�ti« No. of Rooms
�7Trarnr.s Width
Height
Condition of exterior
Condition of interior
Present location
,. Street Lot Block Tract
Proposed location
No. Street Lot Block Tract City
Site location on new lot
06
Route on which building is to be moved_ /"0
Tax certificate filed Ownership certificate filed Pee Deposited
Other information