100APPLICATION FOR HOUSE MOVING PERMIT
0
C- 'CITY OF CUPERTINO
PfiAY-F, /
r I, 1Permit No. /00
Cp iyl�/ CUP
oe^ ER . Pee $ -fJ 0"y
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�
/(B
J, Approved>
CONTRACTOR, AGENT BUILDING INSPECTOR
Phoner.-.445555/7...............
Building contstructed of No. of Rooms
MATERIALS Width
Height
Condition of exterior
Condition of interior
Present location 9 O
��NJJo. S eet Lot Block Tract Ci[
Proposed location_/`—�'�"
No. Street Lot Block Tracy
Site location on new lot /t
ute on whichilding is to be moved
Tax certificate filed Ownership certificate filed Pee Depositedtd
Other information