HomeMy WebLinkAboutPermit Building 2005-8-24
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00996
ISSUED: 08/24/2005
APPLIED: 07/27/2005
EXPIRES: 02/24/2006
VALUE: $ 60,000.00
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3032 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: 1703220002200
Springfield TYPE OF WORK: Commercial Miscellaneous
TYPE OF USE: Alteration
PROJECT DESCRIPTION: Remodel Existing Building for Carls Jr and Green BuriUo.
Commercial
Phone Number: 312-960-5000
. Owner: GA TEW A Y MALL PARTNERS
Address: 110 N WACKER DR BSC 3-04 ATTN PROPERTY TAX ADMIN
CHICAGO IL 60606
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor License EfJliration Date
ESSEX GENERAL CONSTRUCTION la~lres yOU, 11/10/2006
REYNOLDS ELECTRJ,TrEN1'ION: Oregon ~e!gregon Uti\I~/08/2007
COMFORT FLOW fn\lOW rules adoPte~:Ys1flb\es are set fgo~6j27/2007
HARVEY & PRICE cq.,,,~,,tion center: ^ .~,^7Io\'l OAR 95~- _ ,t.1I/3112006
'!-: -- 1.:': .1t.....t- Ol \1\~ 1'....- - .
, ~lD}~DIDE,~OItM'\rn::~nete\ep\'lOne "
009. H..p !:enter. lNO ui:rw NotilicatlOn .
1!1d1'tlSJPrles. Oregon I I 4) Lot SIZe:
rM~illJltro'f:5fitU~'M'~~800-332-234 . Sq Ft 1st Floor:
Type otGl\\ll~r Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
, Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
A-2
VB
I DEVELOPMENT INFORMATION I
Phone
541-342-4509
541-343-7297
541-726-0100
541-746-1621
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
M(\TH~E: _ _ ,.~. ,r ",noli
- ..- '''IAlL t.^rlfll.... II ,..-
I PUBLIC I~ROVEMENTSI ER 1\-\\S PERM\1 IS N01
AU I nunlLLU ~..D ...' rn COR
MENCED OR IS Sldewalk)ffiype:
COM :"~''''- .
ANY 1 BO DI\Y PERIODownspoutsillrains:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fully Improved
Yes
Notes: Storm drainage piped into existing 8/12/2005 CAS
Paee 1 of5
To Storm Sewer
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Use Bid Amount
Estimate
Pavine
Fee Description
Plan Review CommlIndlPublic
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 70/0 State Surcharge
Add, Alter, Extend Circ
. Add, Alter, Extend Circ Ea Add
Building Permit
Minimum/Adjustment Mechanical
Paving
Plan Review Fire & Life Safety
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Vent Fan
Total Amount Paid
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00996
ISSUED: 08/24/2005
APPLIED: 0712712005
EXPIRES: 02/24/2006
VALUE: $ 60,000.00
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$1.00
$1.00
Square Footage
or Bid Amount
56,378.00
3,622.00
Value
Date Calculated
Total Value of Project
$56,378.00
$3,622.00
$60,000.00
08/17/2005
08/17/2005
~ li'PPo P~\lU
Amount Paid
Date Paid
Receipt Nnmber
1200500000000001076
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
2200500000000001147
$266.27
$10.00
$69.06
$44.10
$43.00
$144.00
$397.95
$27.00
$60.60
$163.86
$5.43
$108.64
$18.00
7127/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
8/24/05
$1,357.91
I Plan Reviews I
Paee 2 of5
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fire Department Review
.
07/29/2005
08/22/2005
OK
Paee 3 of5
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00996
ISSUED: 08/24/2005
APPLIED: 07/27/2005
EXPIRES: 0212412006
VALUE: $ 60,000.00
GRG
Plans Review: Remodel of
Schlotzky's Deli to Carl's Jr and
Green Burrito. Job
#COM2005-00996. Occupancy
Classification: A-2. Construction
Type: V-B. Occupant Load: 94.
Maintain address numbers in
contrasting color from the
background positioned plainly
visible and legible from the street or
road fronting the property (2004
Oregon Structural Specialty Code
501.2 and 2004 Springfield Fire
Code 505.1).
Provide fire extinguishers with a
minimum rating of2-A:10-B:C
every 75 feet of travel distance. The
top of the extinguisher(s) shall be
between 3 and 5 feet above finished
floor (2004 Springfield Fire Code
906).
Provide illuminated exit signage
meeting requirements of 2004 OSSC
1011.
Above the main exit door, provide
sign stating "TillS DOOR MUST
REMAIN UNLOCKED DURING
BUSINESS HOURS" if key locking
hardware is employed (2004 OSSC
1008.1.8.3, exception 2.2).
Subcontractor shall provide
submittal plans and cut sheets of a
commercial kitchen hood and duct
fire suppression system(s) meeting
UL 300 for review and approval by
the Springfield Fire Marsbals Office
for all cooking surfaces producing
grease-laden vapors (2004 SFC
901.2).
Provide K-rated extinguisher within
30 feet travel distance of
commercial-type cooking equipment
involving vegetable, or animal oils
and fats (2004 SFC 904.11.5).
. . Lll r OF SPRIr'lihl'1ELD
Building/Combination Permit
Status Issued PERMIT NO: cOM2005-00996
225 Fifth Street, Springfield, OR ISSUED: 08/24/2005
541-726-3753 Phone APPLIED: 07/27/2005
541-726-3676 Fax EXPIRES: 02124/2006
541-726-3769 Inspection Line VALUE: $ 60,000.00
Initial Review 07/27/2005 07/29/2005 APP LLH
Plannine Review 07/29/2005 08/03/2005 APP EMM No change of use. Restaurant to
Restaurant.
Public Works Review 07/29/2005 08/12/2005 APP CAS Storm drainage SDCs for new menu
board into existing system 8/12/2005
CAS.
Structural Review 07/29/2005 08/08/2005 WE JMP See attached documents for 10
, structural comments faxed to David
Beckman. RIck Fegles at Harvey
and Price will call with plumbing
data when the scope is determined.
Les with Comfort Flow will call with
mechanical data when the scope is
determined.
Structural Review 08/17/2005 08/1712005 10 JMP WI. Received emailed response
letter.
Structural Review 08/2212005 08/22/2005 APP JMP Received final internal approvals.
SUB Review 07/29/2005 08/05/2005 WE JF JMP called Texture at Essex to
request 2 sets of energy code forms
and worksheets.
SUB Review 08/10/2005 08/2212005 10 JF JMP received a mechanical plan and
some energy code forms and
forwarded them to Jack Foster.
Approved.
SUB Review 08/12/2005 08/22/2005 APP JF JMP received electrical drawings
and energy code forms from
Reynolds Electric and forwarded to
Jack Foster.
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.in, will be made the following work
day.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Drywall: Prior to taping.
Final Fire Department. After all requirements of the Fire Department have been met.
Final Building: After all required Inspections have been requested and approved and the building is complete.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough MechanIcal: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Paee 4 of5
.
. CITY OF ~rK11'1ljNJ<..LD .
Building/Combination Permit
PERMIT NO: COM2005~00996
ISSUED: 08/24/2005
APPLIED: 07/27/2005
EXPIRES: 02/24/2006
VALUE: $ 60,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
SUB Final: After all required energy inspections have been requested and approved.
SUB Ceiling Grid: Interior Lighting
SUB Exterior Lighting
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall he done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at aU
times during construction.
t.?/::li~~~~
B124/ns
Date
Paee 5 of5
225 FIFTH STREET. SPRINGFIELD, o'R 97477 . PH:(541)726-3753 . FAX: (54!).q!;!~~89
ELECTRICAL PERMIT APPLICATION ~,o\~.,>"o"Q, ..
/ . I ~ ,,~~' ",," ~
~.iry~;;~:;:';:::~~~I:~l~~~~~te :~;~~:;:i~:~tf~O ~=~~~~~)~~~~~
\)" .}.v
3o~-z.. Qz.A:\E~t!'N '-:2-- \.I."-E.E.:\. ;" ,
A. ~~WR~d€~m~siif~~~jMmti!F~ti:ii~r\~'iair~iii1f"~.iliTJ~~1
LEGAL DESCRIPTION --==>~..".." oc.'<.. "-=-""""""...,,..R.,,'......,JL ' "., ..
l"1 O~,--'L 00 0 z.. '"l..OO Service Included
JOB DESCRIPTION
CA~Lg. J\i?-.
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work i~TT Modular Dwelling Service or $5000
Suspended for 180 days. A ENT1CWe.Qfegon law requires you Iv '
'" .{00Wrules,aOOot""'.h....tJ",r ","
~flcbNfKA:crOR1INS1:,:jTT::i~'4"floN:o.Nm ic ti ':1;,. '....~.r~.~~l.n91~~~~~I~u,I,i~.t't(Ait~ri;~~~i:~lb~ti~ii~t~
2. ;~~""""=".,,"'.w~,,"-""''''"'' ......,,",...."'.W'i'.' ,.. a O~~~,'i'1R~~ftl~.",~~Ylli..;,.'"""""""",_ '~''''''''''C''''''''''
C' ,. . - In AR 952-001-0010 through OAR 952-001-
Electrical Contractor ~: nt'. \(\ =:. F=-\ frt\rm(f~ You ~dl.,1'ffi!rPt:156~es of the rules Ly $ 63,00
'" . ~ ,'.,,\ ' " calling the28br\\lW,s IPJ6?g!tl1W~elephono $ 75,00
Address ;"2 \ -j=, LU.;:.I t\'u '<e number for4..~fl<l9tf}.!'f40tificatiol' $125.00
_," ,~ ',_ Cer60t iSnjpt!.Q)19~~~~I). $163.00
Phone ">.t--:),j,,,{-,_) Over 1000 AmpsIVolts $375.00
Reconnect Only $ 50,00
r- c C('i ~l"'\~'
J
City
Supervisor License Number ',:) S'~ Co 3
C 1,,'t:T}~",'.nI(;;Ii,'r'::'~:""S'~'~;",',~j,-;,"{'~,'':-~,F-' 'j;';;:,d\~~,;"d';;.o,l'9;''''1';;;I~ft!~~fi,:;~"'il,-~~i;~;!!:>!l'',,1;di.I'J,r~ti'M->r:~J
. f(l'.~porar:r.:: .~liVlC~rOr:l.,;~.__ ~~;'~..{I,i=i~.:ltii:';.~~+.\!J~?l:iW~:&) ;~??i~~~.:f~
Expiration Date \ D .I ,...., II ~)c:,O J Installatlon, Alteration or Relocation
200 Amps or less
Constr, Contr. Number \ 'l ';:;( 'f:, ':::) 201 Amps to 400 Amps
J / 40 I Amps to 600 Amps
Expiration Date C',~JC ~ ;~;),QD\
, Over 600 Amps or 1000 Volts see "B" above,
Signature of Supervising Electrician D. ~lj~~~~~ifGi~tS'~;~~~~~~:1.;r~~~~~~1t;~l~
I:: ,./J New Alteration or Extension Per Panel
.,-,,'~ ~ One Circuit ( $43.00 t\-;"OC)
Each Additional Circuit or with
49> t4t!;-,m
Own s Name &"T"E-~'I.' ~LL ?A~S. Service or Feeder Pennit $ 3.00
E. ~Mi~t~li~~~~:~~'(S~i;i~~f;~d;;,~~fti'~ltia;(jj~~E;lh~Ih;tiliI~ti~~.~
Address nO tl. iJ-f -ACt~Q \)'!Z.. ~sc. ;-06,.- "..., ,," ...', ,~, _",,, '""",,,,-.~._^,,;... ",~,",,,,,,,,-=' c...., , '''''1
City C~\C.i\.6.D, l L. Phone (:l>\'t."{\(,D. 50:0 Pump or irrigation $ 50.00
(; C)bO~ Sign/Outline Lighting $ 50.00
OWNER INST ALLA nON Limited EnergylResidential $ 25,00
The installation is being made on property [own whichNOTic[;~imited Energy/Commercial $ 45.00
is not intended for sale, lease or rent. THI~iPL~Hm'f:I~~~~i.t~eriiJt~fnSpecti6h~F:~qfs~s.oo + Surcharges
AUTb1Qltl";'i:+\'[17i~.fR'1n:ol.t~:.nRMJif,.J5,Ng.;r\...,'i':":~
~.rSUBTOTA'L:OEABOV~fe?'o' ""1'(' ~..~";;-,'/; ;)
COMM~t::h!\'J'~I-l;';'H"~i~~\W!'II'IJ. ."':d:", r:fI~':;;".,:i~t.:::?~,'
....,..........~....
ANY 18a%lstihrs.Prbh'a?ge
10% Administrative Fee
$ 50.00
$ 69.00
$100,00
Owners Signature:
Inspection Request: 726-3769
TOTAL
\~l.QJ
\.~.~
l% .tb
'Ll ~ .1')
Shared Drive(T:)/Building Forms/Electric31 Permit AppJic3tion j.OJ.doc
. ATTACHMENT A
CITY R1NGFlElO SYSTEMS DEVELOPMENT CHARG.HEET
JOURNAL OR JOB NUMBER C0M2OO5-OO996
NAME OR COMPANY: Carl's lr, and Green Bunno (lCK Restaurants.lnc.)
LOCATION: 3032 Gatewav St
MAP & TAX LOT NUMBER: 17 03 22 00 02200
DEVELOPMENT TYPE: Replace existing fast food. restaurant
NEW DEVELOPED AREA (S,F,~" 3.652,00
EXISTING DEVELOPED AREA (S,F,): 3.652,00
TOTAL IMPERVIOUS SURFACE (S.F.): 24.536,00
..,"~
_\\0 ....
ITE:
ITE:
LOT SIZE (S.F,):
934
934
Existing building new menu board
I STORM DRAINAGE
IMPERVIOUS SQ. FT,
x
$ 0.323 PER SF
TOTALSTORMDRAINAGESDC:, $ 108.64
336
2 SANITARY SEWER-CITY
Nonewfixturcs
A. REIMBURSEMENT COST:
NUMBER OF DWs
B, IMPROVEMENT COST:
NUMBER OF DFU's
(SEE REVERSE SIDE)
o
x $ 25,07 PER DFU
o
x $ 19,07 PERDFU
$ 44,14
TOTALLOCALWASTEWATERSDC:, $
:lJRANSPORTATlON
No new trips
BlOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR
NEW
A. REIMBURSEMENT COST:
3,65 x 496.12 x $ 19.09 PER TRlP x 0,5 NTF L $17.291.111
B, IMPROVEMENT COST:
3,65 ' x 496.12 x $ 84,19 PER TRIP x 0.5 NTF $76.269.861
EXISTING $ 103,28
A, REIMBURSEMENT COST:
-3.65 x 496.12 x $ 19,09 PER TRlP x 0,5 NTF -$17.291.111
B. IMPROVEMENT COST:
-3,65 x 496.12 x $ 84,19 PER TRIP x 0,5 NTF -$76.269.861
TOTAL TRANSPORTATION REIMBURSEMENT SDC:' $
TOTAL TRANSPORTA TlON IMPROVEMENT SDq $
TOTAL TRANSPORTATION SDq $ I $
4 SANITARY SF.WF.R - ~
NEW:
A, REIMBURSEMENT COST:
NUMBER OF FEU's 3.65 X $2.099,76 PER FEU
B. IMPROVEMENT COST:
NUMBER OF FEU's 3,65 x $7.471.08 PER FEU
EXISTING:
A, REIMBURSEMENT COST:
NUMBER OF FEU's -3,65 X $2.099,76 PER FEU
B, IMPROVEMENT COST:
NUMBER OF FEU's .3,65 x $7.471.08 PER FEU
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$7.668.321
.1 $27,284,391
-$7,668.321
-$27.284.391
$
$
$
$
P
1 08.64 ~
TOTAL MWMC REIMBURSEMENT FEE:
TOTAL MWMC IMPROVEMENT FEE:
MWMC ADMINISTRATIVE FEE:
TOTALMWMCSDC:,
SUBTOTAL (ADD ITEMS 1;2.3. & 4)
, $
5 ADMINISTRATIVE FEES'
BASE CHARGE (SUBTOTAL ABOVE)
$
108.64 x 5% $ 5,43
TOTAL TRANSPORTATION ADMINISTRATION FEE:' $
TOTAL SEWER ADMINISTRATION FEE:' $
CheYljL SLalj"'-"lur 8/1212005
S~~~~8JRL'5 JR & GREEN BURITTO,3032 GA-rl1\\.J.~
TOTAL SDC CHARGES
, $
114.07 \
, JULY 2004
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT - DRAINAGE FIXTIJRE UNITS
(NOTE, FOR REMODELS. CALCULATE ONLY THE NET ADDmONAL FIXTIJRES)
Carl's Jr. and Green Buritto (JCK RestaurantsJne.)
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASElOIUSOLIDSlETC.
INTERCEPTORS FOR SANDI AUTO W ASHlETC,
LAUNDRY TUB
CLOTHES WASHERlMOP SINK
CLOTHES WASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRIGERA TOR/W A TER ST A TIONIETC.
RECEPTOR FOR COMMERCIAL SINK! DISHW ASHERlETC.
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: COMMERCIAL. RESIDENTIAL KITCHEN
SINK: COMMERCIAL BAR
SINK: WASH BASINIDOUBLE LA V A TORY
SINK: SINGLE LAVATORYIRESIDENTIAL BAR
URINAL, STALllWALL
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INSTALLATION
MISCELLANEOUS:
FIXTURES UNIT
NEW OLD EOUJV ALENT
3
I
3
3
6
2
3
6
12
I
3
2
2
3
2
2
1
5
6
3
NUMBER OF EDU'S. ,
TOTAL DRAINAGE FIXTURE UNlTS=
.EDU (Equivalent DwellinR Unit) is a disc~ equi~cnt to a single family dwelling (20 DFU) set at 167 gallons per day
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
0'
o
o
o
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARA TEL Y
YEAR
ANNEXED
1979 or before
1980
1981
1982 '
1983
1984
1985
1986
1987
1988
1989
1990
1991
YEAR
, ANNEXED
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
RATE PER $1,000
ASSESSED VALUE
RATE PER $1,000
ASSESSED VALUE
iI1~'I~
fC;;;"",~$4;40j
~~~f~~~:~~~
~~" ,',~f,,,..,$3,22J
. [i~~i~),i~
fr~1~~~~imt:r ;'~~~~ :4';
"'~"""cr" ~1.:~5,\1
il~1
~I'" """""$0.28,,,
ml:~;;;~~~}~~;~~'~
, ~~~~f~~i~lg~!~
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
x
X
CREDIT TOTAL
COM2005-00996.CARL'S JR & GREEN BURITTO.3032 GAT <!NAY
$0.00
$0,00
$0,00
1 JULY 2004
225 Fifth ~treet
Sptingrl~ld, Oregon 97477
541-726-3759 Phone
.
~,',~~,-,~- ;
~,~~,
~ity of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
COM2005-00996
RECEIPT #:
2200500000000001147
Date: 08/24/2005
Description
Stonn Drainage Impervious Area
SDC Sanitary/Stonn Admin
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Plan Review Fire & Life Safety
Building Pennit
Paving
Vent Fan
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Paymenl Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Check
,j
:'
;,
;r
:'
.;
:.
;,
:,
;'
"
J
"
;,
8/24/2005
'i
JCK RESTAURANTS INC
djb
3405
In Person
Payment Total:
Page lofl
1 :44:25PM
Amount Due'
108.64
5.43
43.00
144.00
163,86
397.95
60.60
18.00
27.00
10.00
44.10
69.06
$1,091.64
Amount Paid
$1,091.64
$1,091.64