91 APPLICCA-TION--FOR HOUSE MOVING PERMIT
fffG�� =�jCITY F'CUPERTINO
CEC 6 1962
Date 195_ Permit No.
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CITY 0F CIJPERTINn Fee$
Application is hereby made to the City of Cupertino for a permit to move the building
described on the reverse side hereof from a to the specified location at the time and date
indicated in accordance with Ordnance No. the City of Cupertino.
xOwner�✓A1Q
By °t Approv
CONTRACTOR, AGRNT - - BUILDING INSPHCTOR
Phone" ... .- .a-----9..jd ...... ' ,J
Building contstructed of No. of Rooms
MATERIALS Width 3'2- ' X q-U t
Height - 7
Condition of exterior elt. C5- ln
Condition of interior
Present location Q S
No. S[Ie Lot Block Tract Cit
Proposed location
No. Strmtt Lot^ n Block— -Tract City
Site location on new lot
Rout on which building is to be moved — / —
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Tax certificate file Ownership certificateY, ed Pee Deposited"
T�c.information
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