113APPLLGATIO" " OR -HOUSE MOVING PERMIT
Lrt CIT ' EF CUPERTINO
�J/U L 16 1963
DateIT\/� aI_��� �.-.�� 9� 3 Permit No. _/ / 3 _I
Pee S � • Od
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.
i
Ownezttl._'4r' l /
Lpproved
BUILDING INSPECTOR
Building contstructed of/%�� 42)
MATERIALS
Condition of extern
Condition of interi<
Present location
Proposed location6
Site location on new
No. Street Lot
No. Street(/ Lot
Route on which building is to be moved
Block
Tract
Tract
No. of Rooms<
Width 9 7
Height,I 7
Tax certificate. filed Ownership certificate filed Fee Deposited2-��
Other information -