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APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
Date Z 6 19)5 Permit No. 17-4
��
Fees Am Per
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�c '
E By�C �L`Y S Approved
in CONTRACTOR, AGENT BUILDING INSPECTOR
Phone ] L /� � Z '
Building contstructed of �,e.An� No. of Rooms /
MATERIALS Width 2,!5--
Height /
Condition of exterior
N
Condition of( ' r�
Present IocatSen'�� r
Stmt Lot lock Trac[ City
Proposed location
No. Street Lot Block Tract ' City
Site location on new lot
N
Route on which building is to be moved
Al
Tax certificate fi d Ownership certificate filed Fee Deposited
Other information