179n AP;PL•1_CATION,JOR HOUSE MOVING PERMIT
® ` �[I�JT�Y OF CUPERTINO
IJUL 16 1965
Date 195_ Permit No. /7
�( CUPERTINO
CITY OF Fee $ �Q
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
J
I7§' Approve
N
r CONTRACTOR, AGENT BUILDING 4NSPECTOR
Phone' --- ---1-d--d...........
Building contstructed
MATERIALS
Condition of
Condition of
Present locati
No. Street
Proposed
No. " Street Lot
Site location on new
No. of Rooms_
Height
Block Tract
Block Tract City
E
Other