177 APPLICATION FOR HOUSE MOVING PERMIT
CITY OF CUPPEERTINO
` Date (n G� 197a� Permit No. / 77
Fee$ ;g) Fec
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.
7—
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65 CONT6ACTOR, AGENT BUILDI INSPECTOR
Phone LZUI Z_
Building contstructed of No. of Rooms/
MATERIALS Width
Height �A
v`/A/ S '
Condition of exterior
Condition of in e
Present locati _
P' o. rr 6 street �Lola� Tract I City
Proposed locatio
No. Street Lot Block Tract City
Site location on new lot
Route on which building is
to be ove C-6
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Ownership.cfiled_
Tax-certificate tVC Fele �post -
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Other information