66 An! CA FOR HOUSE MOVING PERMIT
r �� OP CUPERTINO
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SEP 21 at 6
Date 195— Permit No.
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C,TY OF CUPERTI U. Pee s�\�
Application is hereby made to the City of Cupertino for a permit to move the building
(' described on the reverse side hereof from anC the specified location at the time and date
(�', indicated in accordance with Ordnance No. �7_of the City of Cupertino.
ti y�
� Owner ' �� E L
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BY Approved
IdCo n —R, AGEN-1 uulLn�CTOR
c�_ylwEX...�.:aay.l..Z .
Building amtstruded of Own - - - No. of Rooms
MATERIALS Width O
Height
Condition of exterior `�l7 _
Condition of interior `I/.1���
Present location_ I I t'� (] G— b C i �_�.I_I Oq o se
No. Street Rd
nBjock Tract \ p City
Proposed location 1-4t l �Rd - t V\b ��A-r�.)I 1 0-a_-41
Nn. Streets Lot Block Tract City o
Site location on new lot o
Route on which buildin is to be moved N • �Q J I r rJGy - �-- ` 2 l<
Tux certificate filet Ownership certificate filed pee Deposited CIO n l!",
Other information