NO PERMIT NUMBER APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CUPERTINO
Date 2- — 19�a Permit No.
y Fee $
0
�] Application is hereby made to the City of Cupertino for a permit to move the building
n: 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.
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CONTRACTOR, AGF.N-� Mo IL ING INSPECTOR
Phone ... _2..-.Z:.P/...Z..... 15 - Ib
Building contstructed of No. of Rooms
MATERIALS Widths—
' Height
Condition of exterior
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