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APPLICWTION�FOOR HOUSE MOVING PERMIT
'1P CUPERTINO
UC 2b 1$58
Date L95_ Permit No. 43
CITY OF CUPERTINO Fees =;2 4 . O 6
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
indicated in accordance with Ordnance No. of the City of Cupertino.
Owner /
Approved
CONTRACTOR, AGENT BUILDING INSPECTOR
Building contstructed of �(Y�iw �� — No. of Rooms.-
N[4fT:RIALS Width
Height /2�w
Condition of exterior
Condition of interior
Present location
No. Street of lock Tract City
Proposed location&�/Yr1_w/ ir7� L1W Yc�-dor N- L✓ ��'°l.
No. Stre Cot Block Tract City
Site location on new lot
Route on which building is to be move�1
Tax certificate filed Ownership certificate filed Pee Deposited
Other information