75 APPLI N FOR HOUSE MOVING PERMIT
]~ QTY
OF CUPERTINO
DAPR 5 102
Date 195— Permit No.
CITY OF CUPERTINO Fee $ o b a
�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
('ff indicated in accordance with Ordnance No. of the City of Cupertino.
Y0
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Owner
v By'� Approved 0.
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CONTRACTOR, AGENT UILDING INSPECTOR
Phone �Y S i
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Building contstructed of No, of Rocgns
MATERIALS Width FS t
Height 1 `�
Condition of exterior
Condition of interior
Present location
No. Street
�Stree�t Lot Block - Tragf"�\ 'ty
Proposed location Wu' \'Tf'_ ^
No. Str Lo Block Tract G
1
Site location on ne -
to 0 which buildings
e�o6 ,
Tax certificate filed Ownershipcertificatefiled Pee Deposited
Other information