1Ate, PL_ICAT-ION FOR HOUSE MOVING PERMIT
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ARF 17 9959 j ff /
Dat195_y Permit No. /
CITY OF CUPERTINO Pee s_c2o —
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-acmrdance-vdh-Ordnance No. _ of the City of Cupertino.
By Approved
CONTRACTOR, AGENT BUILDING INSPECTOR
Building contstructed oft/A� No. of Rooms /
MATERIALS Width
Al Height_/ %
Condition of exterior
Condition of i
Present
Lot
Site location on new
Route on which building is
Tax
Other
Pee