104 PP�L�'1C TIO,N�FORHOUSE MOVING PERMIT
RJU
`�CIT'tS�{� CUPERT[NO
4 1963
Datei ;� _'3 Permit No
.
rn CIT F IM' Fee
/?:::
Application is hereby made to the City of Cupertino for a permit to move the building
'"/i described on the reverse side hereof from and to the specified location at the time and date
indicated in a cordance with Ordna e No. of the City of Cupertino.
Owner
c
v
V /
By�,C APprol e
V1
CONTRACTOR, AGENTBUILDING INSPECTOR
Phon
/ 111111 2 2o-i..z........
Building contstructed of No. of Rooms
;MATERJAqLSWidthHeightCondition of exteriCondition of iteri r Present location -
o. S et Lot�' HIS - ract City
Proposed location 41 S �'
No. S ectt `Q_-P49ck Tract City
Site location on new lot
Rite ch building is tbe mo �d
1
Tax c rtilicate tiled Ownership'certificate filed Fee Deposited
Other information