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APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
Date Z190 Permit No.
Fee$ O EE.
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.
Owner7��'...r�i7
v
Byiyr•% Approve
;n CONTRACTOR, AGENT BUILDING INSPECTOR
Phone _.............. ..........................
Building contstructed of No. of Rooms
MATERIALS Width
Height
Condition of exterior
Condition of interior
Present location-1-1-1-1--
No.
ocation _
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 move +
Tax certificate. filed Ownership certificate filed Fee-Deposited
Other information