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PLICATIOWFOR HOUSE MOVING PERMIT
JUN 20 99�11Y ,CUPERTINO
Wi Date IvITVt'� r G i i13 Permit No. 1—�
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I Fee $ �(0
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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
`J indicated in accordance with Ordnance of the City of Cupertino.
V Ownert-
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Approve -
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CONTRACTOR, AGENT BUILDING INSPECTOR/
Phone ..L:G.�.C7..��...........
Building contstructed of ` ii -A-! No. of Rooms
MATERIALS Width
Hetght
Condition of exterior
Condition of interior
Present locations _
--�No. r trL� Lot Bloc- /Tra Cit}
Proposed location - a= �—
No. Street Lot Block
Site location on new lot
Route on which building is to moee
i -
- 00
Tax certificate led / Ownership certificate filed Fee Deposited'
Other information