28 APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
Date19Y.L4 Permit No. ge
Fees. O --rE[-
�' 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
indrr n ccordantt w' Ordnance No. the City of Cupgrtino.
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LZ CONTRACTOR/, AGENT BUILDING INSPECTOR
Building contstructed of No. of Rooms_
MATERIALS Width
Height
Condition of exterior
Condition of interior
Present location
No, Street Lot Block Tract City
Proposed location
No. StreetLot Block Tract City
Site location on new lot
r
R e on whic?il ' s to a moved YJ4 ,AO 6U
Tax certificate filed Ownership certificate filed Pee Deposited
Other information