11 APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CCUPERTINO
Date 42 195./ Permit No.
Fee S_
Application is hereby made to the City of Cupertino for a per�t`fo'�rflo�'bulding
^'1 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
1
by Approved
CONTAACIOA, AGYN]' BUILDING INSPECTOR
/%
Building contstructed of // -t 1 i No. of Rooms
MATERIALS Width 44G�' G
Height /G
Condition of exterior
Condition of interior
Present location
N ` Street L Blocky T ct City
Proposed location_-I �«'�� �
No. Str t Lot Block Tract City
Site location on new lot
Route on which buildi is to be moved
..y/ -� -
4:i�dn
Tax certificate filed Ownership certificate filed Fee Deposited
Other information