16 APPLICATION FOR HOUSE MOVING PERMIT
�InYOF CUPERTINO
Date r? T 5— Permit No.
O�
��YY (n�CC n j fla�n
Fees ,-2,0
Agpl�c�tion"is�he)m011tKity 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
indicateZin cordance with Ordnance No. of the City of Cupertino.
Owner
1
g)� Approve
CONTRACTOR, AGENT BUILDING INSPECTOR
Building contstructed of No. of Rooms_
MATERIALS Width
Height
Condition of exterior
Co n of interi r� /
sent ocation_ .� 1-1
Block Tract City
ro o d a ' n Block Tract City
ocation on new
to on which bnildi to be ved�
Tax certificate filed Ownership certificate filed Pee Deposited
Other information