173 61s- ;
FMAY PLICATIONFOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
14 1965 u'
Date A I��- >��- Permit No. 173
loll 1 JI UUM INU p-a
Fee$ c2 0
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
v indicated in accordance with Ordnance No. _of the City of Cupertino.
tCl
Owner
V
By Approve
CONTRACTOR, AGENT BUILDING INSPECTOR
�hone2.f ...�`� Z .
Building contstructed of �./1�'G�-*-r No. of Rooms s� .
MATERIALS Width 2V
Height
Condition of exterior ✓� r°�'
Condition of interior
Present location fNo. Street Lot Block Tract City
Proposed location-7U0
No. Street Lot Block Tract Ci
Site location on new lot
Route on which building is to be moved
Tax certificate filed Ownership certificate.filed Fee Deposited
Other information