Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
2904 (4) TIr-m.q&ADDITIONAL CHARGE
Or CUPERTINO
1964IJ B � 1. G INSPECTOR'S OFFICE.
Date ......... . .... ---- ---- .............. 19-.. Permit No. .
�x
ToCl T-)(. PEMR.'..zz-�- i
...................... ........... .........................
Address e—c,�
.................. ......--................. ....
................... ................ ................
Reason ............. ..
...... ........... .. -............................. ------ ........—
....................... .... .................. . .............................................. .............................
..................... ..................... ............................................ ............................. .............
.4mount$ . ...
..V�"/59-300....... ...... Signed .....
B
4 �
y GA ;
�c .o
O
rm
� � O
.> / g .
$ z
\ &
,
f +
-
n § �
/ �
] ] �
} �
C) ■ E / ƒ \ (
� .
\/ .
