120 APPLICATION FOR HOUSE MOVING PERMIT
963
963 EC�ZTY
OF CUPERTINO
�
Date 195_ Permit No._,/�(1)
C� CITY OF CIJPERT7,`'` Fee
Application is hereby made to the City of Cupertino for a permit to move the building
described on the reverse side hereof from an4 to the specified location at the time and date
indicated in accordance with Ordnance No(�f the City of Cupertino.
Nom:
Owner
� y►
�\By Approv,
h
CONTRACT /AGENT BUILDING INSPECTOR
01
n,, Phone �"' /
Building contstructed of iLC No. of Rows
MATERIALS Width
Height
Condition of exteriora.
Condition of interiors./ ti
Presentlocatiot/�tO2S +} � Cd .��s•� `'` f
Nro. S,trrt Lot Block Tract City //Av
Proposed location 4�
No. Street Lot Block Tract sty
Site location on new lot
Route on which building is to be moved OLe. �.�
"I" w l o. . —.) 94 tr ncy � S FD
Tax coert� Qe � Qw{t rsh pcertificate filed �aFewewDesited
41)
Other information aaO- tSeP