111 APPL�A Id FOR-HOUSE MOVING PERMIT
CITY SOF CUPERTINO
\�]y�j .f .�JUL 3 1363 ,/
V' 'Date — , Perm
C. it No.
L� , r Liu tl1 �.T Fee $ r;�-O, Vo
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 r/es
U
Approved
r
CONTRACTOR, GENT i -R ILDING INSPECTOR
Phone ------------.._...------------------
wilding contstructed of No. of Rooms
•„� _ 7ALS Width
�- Height -
Co77
ndition of exterior b
Condition of interior
Present location
No. Street Lot Block Tract City
Proposed location
No. Street .Lot Block Tract City
Site location on new lot
Route on which building is to be moved _
Tax certificate filed Ownership certificate filed Pee Deposited
Other information