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APPLICATION FOR HOUSE MOVING PERMIT CITY OF CUPERTINO i Date 1 Z`— , 19V Permit No. 3 4�7' Fees AJA FES Application is hereby made to the City of Cupertino for a permit to move the building described on the reverse side hereof from agd1�p the specified location at the time and date indicated inin'accordance with Ordnance No.a-y of the City of Cupertino. Owner Com— / /2,,,S — y y Approved um7n, ONTRACTOR, AGBNT HII[LDING INSPHCTOA 7Pho - ... ..................... Building mntstructed of No.of Roo MATERIALS H idlh� ' Height Condition of exterior Condition of interior Present location No. Street Lot Block Tract City Proposed location No. Street Lot Block Tract City Site'logation on new lot Route on which building is to be move — S�c�c�s /3LA '-�F5 Jie. Aw+9�2 Tax certificate filed_ Ownership certificate filed_Fee Deposit4-46P©, Other information • TO DEPARTMENT • RECEIPT 0 - • CI'T'Y OF CUPERTINO • COL LECTOWS OFFICE • No.008592 • • DATE 1 � }1 1 719RECEIVED • FROM • ��.t ' �.�. t` ADDRESS C w � � � Ll,v« • • SN LN I EC[� ONORRDER G1I 1 FDOLLARS CENTS ---REaEIvpD ' lCU•�. - • BY