HomeMy WebLinkAboutPermit Signage 2011-2-28
"
,It - ~vt1n jJkfrlC?V-j
C:,-:O- ~"::7\r~<t');;, ::L'::~:r:;
,
CITY OF SPRINGFIELD, OREGON ,"
=1225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
o CityJobNumber >PIL~Il-003/J .
'~j Site Address: 5155 rnOj () S+
~ Assessors Map I 70 Z. :s '3 Lf L{
~j
ij
'J~j
~j
~j Description of Proposed Sign(s): (Please check and complete all appropriate infonnation)
ir. V WaIl Freestanding Projecting Roof
~j V Single Face Double Face Billboard Other
~r-j Square Footage: 3 [; . OJ t/J Total Height above Grade: ;q,
f . / j, 4' ~I II 1~(/ 'I. I'
./ Vertical Dimension of Sign or Enclosure: '7 -- 1'1_ Horizontal Width of Sign or Enclosure: J-
~ Dimension from Grade to Bottom of Sign Enclosure /5' Electrical InstaIlation: Vyes _No
(If yes additional electrical pennit required)
/ I 0':.
~ Material Sign is Constructed of: a v;n {)....C..r'1/; (, jrJiA.i f\ + VI t1 Cf Value of Sign: /-'100
OJ~j
r j List ALL existing signage and attach a photograph or each sigo:
r j (a) Type
oj (c) Type
~j
~
~j Construction Contractors Registration Number: I (, ( ') I 3
/"r
(:, ,')
'c. ..;;.
Tax Lot:
Dogol
Owner:. ~fLltJ :;, Jv:1<)4/'75 J(\ G tV, Ok 0
Address: tJ ..6t1 ;; 0
City /30 (5.-€-_
Business Name, Finn, etc. 11-1 A~)IJ/7 ~
~ llr~,
Phone:
State
IO
Zip [3 ') ;)("
Marquee
Sq. Ftg.
(b) Type
Sq. Ftg
Sq. FIg.
(d) Type
Sq. Ftg.
Contractor/lnstaIler: T/n./lCi'--( kill) :)/1/)::;
. :iI-A ./
Address: 4fl5/ (J.) /. v-c
City: 6./~
Phone:.')'I/' '-I 9'1. f<I S'J-
State: OK
Zip: C; 7 y.a 2-
Expires: 1- ( -/3>
OFFICE USE
=1 Sign District: C L Zoning: C C
~' '~ By signature, I state and agree, that I have carefuIly examined the completed application and do hereby certifY that all
r . ,I infonnation herein is true and correct, and I further certifY that any and all work perfonned shall be 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. I
'J~l further certifY that only contractors and employees who are in compliance with ORS 701.055 will be used on this project.
~
I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the
street, that the pennit card is located at the front ofthe property, and lhe approved sel of plans wiIl remain on the sile at all
times dUrinl!);staIlation Oflhe~(S). (. ~
Signature ~ J~ Dale cJ.Jf; (I
Shared Drive(T:)'Buildiag Forms/Sign Permit Applicationl-Q2.doc
,6 - /1/ w-!5tJ/J 5
r~?~,. ~rrs,~,:;;=:-l,~~
CITY OF SPRINGFIELD, OREGON .
=1225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
Q City Job Numb..
IJ~j Site Address: 517-) ma.;/1 Sf-
JU\
~ Assessors Map---.J ,02 3 '3 Lf l.{ Tax Lot:
~j Owner: ;lAw fJ-/JurT-sO/l5.Ir\c CI/l O/LiO 6~;??
ij Address: ~O /.SO X J-O
IJ!Il!\j City j30 YL
,;11 Business Name, Finn, etc. ;+1 WI 50/)::>
Cj Description of Proposed Sign(s): (Please check and complete all appropriate information)
,- V Wall Freestanding Projecting Roof
CJ VSingle Face Double Face Billboard Other
~'-j Square Footage: //1 ?j. * Total Heigh:al~ve Grade: :;}.()
(1 '" 3P,/11
/ Vertical Dimension of Sign or Enclosure:: .../ I Horizontal Width of Sign or Enclosure:
I Dimension from Grade to Bottom of Sign Enclosure IC) Electrical Installation: ~es _No
(If yes additional electrical permit required) (/
~ Material Sign is Constructed of: .::1 Iv!Y\ a Crr;li C, /lO"'-I1+' vi f11.j I Value of Sign: >>600 0_
IJ~l
r 1 List ALL existing signage and attacb a pbotograpb of eacb sign:
r j (a) Type
r 1 (c) Type
~j
@)
~j
/.
( . i
..'----..~
sf'It..:zot{-ac 5/~-
c>c,8'c,(
Phone:
State
nJ
. rF/}$'?0
ZIp
Marquee
Sq. FIg.
(b) Type
(d) Type
Sq. FIg
Sq. Ftg.
Sq. Ftg.
Contractor/Installer: I J'NJ1 ~ . 1::-1115 5)/17 5
Address: 4IJ.JI UJ I ~r /f~
City: (:::;;~
Construction Contractors Registration Number: / fo 13 I S
Phone: ')41. <j.fy, IV fj 1-
Stale: (j;2
Zip: '17V();J-.
Expires: C; -( - ( ~
OFFICE USE
=1 Sign District: C L Zoning: L C
~' j~ By signature, I state and agree, that I have carefully examined the completed application and do hereby certifY that all
r "I information herein is true and correct, and I further certifY that any and all work performed shall be 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. I
IJ~l further certifY that only contractors and employees who are in compliance with ORS 701.055 will be used on this project
rrI11
I futther agree to ensure that all required inspections are requested at the proper time, that project address is readable from the
street, that the permit card is located atthe front of the property, and the approved sel of plans will remain on the site at all
tim. es durin~ i1'tallation of the sig" L . I
SIgnature lLl~~ Date ;;)-/:J'?; / I
Shared Drive(T:)lBuilding Forms/Sign Permit Application 1-o2.doc
t - 5-/cLr buct:5
CITY OF SPRINGFIELD, OREGON
~,:-=~::';:((!::;=E:':~..:::
,
=1225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
Q City Job Number.
l)~j
~
~j
ij
1)~1
~j
~j De~on of Proposed Sign(s): (Please check and complete all appropriate information)
f/\., ~all Freestanding Projecting Roof
~j - Single Face Other
~fj j Square Footage: 1& cP
, Vertical Dimension of Sign or Enclosure:
/J 1
Dimension from Grade to Bottom of Sign Enclosure 1'-1 Electricallnstallation:_Yes _No
(If yes additional electrical permwequired) <I{/
JU\ Material Sign is Constructed of: CdU;J1 0 U<;lic, fla.//I'!~ 1/ il"1! Value of Sign: / (}(}cJ-
~ If '
l)~j
r j List ALL existing signage and attach a photograph of each sign:
r 1 (a) Type
\ 1 (c) Type
~1
~
~j
'~J1.:
(<~)
"L-._...
Sf'ILZCIl- (:)03/J
Site Address: 315-) /Y){}J/I 5+
Assessors Map~ 70 z.. "3 "3 Cf 'f
Tax Lot:
cc g-O I
Owner' lUau.) fl}JurhrJ//5 J:n<!...-11U1 ()/i j 0 C'~r,t!?
Addres~: /O,6a)( dO '
City IfCJi-S-C. State TO
Business Name, Firm, etc. Iff ~ 011-5
Phone:
Zip f' 3'7 ).(.
Marquee
Double Face Billboard
Total Height above Grade, _.;;L3 '
4'
1...1 '
Horizontal Width of Sign or Enclosure:
Sq. FIg.
(b) Type
(d) Type
Sq. FIg.
Sq. Ftg.
Sq, FIg.
Contractor/Installer: rZ'7~ t:':;15/j'fl5
Address: 4051 { - It-
~
City: b.J~,----
I
Construction Contractors Registration Number:
Phone:iC/t. <ffY. (<f g;,L
/0 (3/3
State: aL
a' '-'
Zip)' 7 yo ~
9-/-(5
Expires:
OFFICE USE
~1 Sign District: C L Zoning: C c..
~' :I~ By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
r . 1 information herein is true and correct, and I further certify that any and all work performed shall be 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. I
IJ~j further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project.
OO~ I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the
1// 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 all
r).. ti~es durin rYe irtallatj'n of the ~(s);t . Y'~
SIgnature L~~ Date J-/;) /
Shared Drive(T:)lBuilding FormsfSign Permit Application 1-02.doc
Electrical Permit Application
I ~(Q)IJP~@~~
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753tFAX(541)726-3689
I~
DEPARTMENT USE ONLY
Sptt. -eo {( - 00 5/ S
Permit no.:
Date:
This permit is issued under OAR 918-309-0000. Permits are nontrausferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? DYes D No
CATEGORY OF CONSTRUCTION
t:t\
WIA.\\ ,5'1 'n;?,.." ".-". ,
,:';,i;,,,; ,..; ,PROPERTY .OWNER
Name: N *t"',o~~l'l.V:5cWS C': r/C .
~I] U,u,oitbC5~-(ti:'buq (U U" .!O:I' ..... ,0'" . V J 1-
Addres : ,..,,, 1\,_.. _~.'''' ,'X+....i.... e., "c.C' :""If rho !'l,1,..,~ hv
City: u '~'I<'6;~7el~i~',~ (State:: tl/(~e:E(ZIP:,~f37Zb
Phone: number for the Orego I F~'Jty I'!om:cauon
. ~^, '"' n. ^,.., ~"
E-mail: t::lllt::l I
This installation is being made on residential or farm property
owned by me or a member afmy immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
CONTRACTOR INSTALLATION
Business name: cA 5 j
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
1\-1E \NORK
'!tOl\ Gt:, M\\ S\-I/l.ll E)ZI'\RE ~~\\1\\1 \S N01
\\~~f.~~ZED U\~;! ;:~~60NED FOR
r~OMN\ENCEO 0 ERIOO. ,,(<0 J .'\,. 1
"Yi800MP ~&\Y
440-2584-) (9/D8/COM) ~
FEE SCHEDULE
Number of inspections per item () Qty. Cost Total
ea. cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or moduJar $ 63.00 $
dwelling service or feeder (2)
Senrices or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
40 I to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63.00 $
20 I to 400 amps (2) $ 87,00 $
40 I to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts., see services or fceders section above
Branch circuits: new, alteration, extension per panel
a Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder not included
Each .pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) 3' $ 63.00 $;gq
Signal circuit or a limited-energy panel, $ 63.00 $
a1teration~ or extension (2)
Each additional inspection: <I) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees $ /81
(Minimum Permit Fee S58.00)
(B) Enter 12% surcharge (.12 x [Al) $226S
(C) Technology Fee (5% offAl) $ 9 II).
TOTAL rees and sureharges (A through C): $2.21 I~
CITY OF SPRINGFIELD
Building I Sign Permit
PERMIT NO: 811-SPR2011-00315'
IVR Number: 811118074477
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
03101/2011
ISSUED:
APPLIED:
03/01/2011
02/28/2011
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci,sprfngfield.or.us
EXPIRES:
VALUE:
08/28/2011
$0.00
SCOPE: Sign
WORK INVOLVED: New
TYPE OF STRUCTURE: Commercial
,}
SITE ADDRESS: 5755 MAIN ST, Springfield, OR 97478-5426
ASSESOR'S PARCEL NO: 1702334400801
PROJECT DESCRIPTION:
Signs. Albertsons
OWNER:
. ADDRESS:
v
Phone Number:
NEW ALBERTSONS INC
. PO BOX 20
BOISE 10 83726
Contractor Type
Sign Contractor
Electrical Contractor
Contractor Name
IMAGE KING INC
IMAGE KING SIGNS
CONTRACTOR INFORMATION ~
Lic Type
eeB
ELECTRICAL
BUILDING INFORMATION ~
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Hazmat:
# of Units:
o
# of Bedrooms:
Sprinkled Building:
Fire Alarms;
Energy Path:
Electrical Specialty Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipal' Development Code:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
Lic No
161313
20-530CLS
lic Exp
09/0112012
07101/2011
Phone
541-484-1482
541-484-1482
Lot S~ze:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other: 0
Occupancy load:
_ 'TION' Oregon law Ireauires yClm\Qnformation
Engineered Fill:to~;~UI[)S ~dopted by the Uregoll ~f~~ih
Fill Volume: Notificalion Center. Those rules are s 2-001-
Flood Hazard Area: OAR 952-001-0010 through OAR 951 b
"" , .' f the ru es y
Land Hazard Area'Ooa You nlay obtam copies 0 h
Retaining Wall: 'V c~': ',nr.1 t", ,0 center. (Note: the telep\. Otne
. -- " UtTt Notl Ica Ion
Soils Report Requ\m~t.bGr lor the Oregon II Y )
Center is 1_800-332-2344 .
Springfield Building Permit
3/1/2011 10:55:18AM
I
NOTICE: IF THE WORK
THIS PERMIT SHALL ~~~~ERM\T \S NOT
AUTHORIZED UNDESRABA~DONED FOR
COMMENCED OR \
ANY 180 DAY PERIOD.
Page 1 of4
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Sign Permit
PERMIT NO: 811-SPR2011-00315
IVR Number: 811118074477
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci,springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
03/01/2011
ISSUED:
APPLIED:
03/01/2011
02/28/2011
EXPIRES:
VALUE:
08/28/2011
$0.00
SITE ADDRESS: 5755 MAIN ST, Springfield, OR 97478-5426
ASSESOR'S PARCEL NO: 1702334400801
SCOPE: Sign
WORK INVOLVED: New
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Signs - Albertsons
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
DEVELOPMENT INFORMATION ~
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Descriotion
Tvoe of Construction
Unit Amount Unit Tvoe
Unit Cost
Value
FEES PAID
I
Descriotion
Amount Paid Date Paid Reciot #
$110,00 0310112011 2011000371
$160,00 03/01/2011 2011000371
~'".'''-''_'_-'--,,--_.._-",_..''' --"~-
$126,00 03/0112011 2011000371
$189,00 03/0112011 2011000371
....---""- --~--'~._'-----,-"-----_."'-~----,,.....-- - ----~..-
State of Oregon Surcharge (12% of applicable fees) $22,68 03/01/2011 2011000371
Technology fee (5% of permit tot;;j)' ----.--;------- "-"'$26~9s -~-- ---o'3i61i2011------.-- 20,','06'037'1
-_ ~~_~..____~.,~___4_.,___.,__.,___w'W".~_~,,_~~___~_______ _ .*___ _ ___'___--" "___
Signs: 0 . 35 Square Feet $80,00 03/01/2011 2011000371
Admin fee (10% of applicable fees) --------$35~ijo----03i0i7i611._._.--. --201 iOO037.1.
Total Amount Paid $749,63
~gns: 36 - 60 Square ~
~igns: 12-1.:2.50 Squ.':'.eF.""~,____~____.___ _.
Sign_~lar: Review
Sign or outline:l~ght.!.~___..,
Springfield Building Permit
3f1/2011 10:55:18AM
Page 2 of 4
S!..R. ING. F.I.E.L~
..1\i\~.0.
..~
OREGON
CITY OF SPRINGFIELD
Building I Sign Permit
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
,Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfield.or.us
PERMIT NO: 811-SPR2011-00315
IVR Number: 811118074477
permitcenter@ci,springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
03/01/2011
ISSUED:
APPLIED:
03/01/2011
02/28/2011
EXPIRES:
VALUE:
08/28/2011
$0,00
SITE ADDRESS: 5755 MAIN ST, Springfield, OR 97478-5426
ASSESOR'S PARCEL NO: 1702334400801
SCOPE: Sign
WORK INVOLVED: New
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Signs ~ Albertsons
Plan Review
~
Deoartment Received Due Date Completed
. Si9n Review 02/28/2011 02/28/2011 02/28/2011
Comments: 3 wall signs - approved'as submitted.
<><>
8.248 Community Commercial and Major Retail Commercial District. These standards apply for all property located in CC
or MRC Districts except those located in the Downtown Sigh District, 1-5 Mall Sign District and the 1-5 Commercial Sign
District:
(1) Single Businesses. Each business shall be permitted a maximum number of three (3) wall signs totaling 350
square feet for all faces.
(2) Free Standing, Roof and Projecting Signs. In addition to wall signs permitted above, one (1) sign from this group
shall be permitted for each approved development area. The total area permitted for a free standing sign, roof or
projecting sign shall be 100 square feet for one face or 200 square feet for two or more faces at a maximum of 20 feet
above grade.
(3) Second Story Businesses and Above. Two (2) wall signs per business shall be permitted with a maximum sign
display area of 175 square,feet for all faces.
(4) Logos are allowed in addition to the permitted wall signs listed above provided the logo is the logo of the
business residing on the premises and provided the total square footage of the permitted wall signs and the logos do not
exceed a combined area of 350 square feet for single story businesses and 175 square feet for second story businesses.
A permit is required for each logo that is being installed based on the square footage of the proposed [ago.
(5) Illumination From Signs On Non Residential Property. External illumination shall be shielded so that the light
source elements are not directly visible from property in a residential zone which is adjacent to or across a street from the
Result
Approved
Reviewer
David Bowlsby
Permit Issuance
02/28/2011 02/28/2011 03/01/2011
Issued
Nancy Machado
INSPECTIONS REQUIRED ~
Inspections
6940 Sign Attachment
6950 Electrical - Sign
6999 Final Sign
Sign Electrical: After connection is made but prior to energizing
Sign Final: After all required inspections are conducted and approved and the sign
installation is completed.
Springfield Building Permit
3/1/2011 10:55:18AM
Page 3 of 4
SP:I.N~.~..
L~~
~()REGON
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Sign Permit
PERMIT NO: 811-SPR2011-00315
IVR Number: 811118074477
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenter@ci.springfield,or.us
PROJECT STATUS:
STATUS DATE:
Issued
03/01/2011
ISSUED:
APPLIED:
03/01/2011
02/28/2011
EXPIRES:
VALUE:
08/28/2011
$0.00
SITE ADDRESS: 5755 MAIN ST, Springfield, OR 97478-5426
ASSESOR'S PARCEL NO: 1702334400801
SCOPE: Sign
WORK INVOLVED: New
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Signs ~ Albertsons
By signature, I state and agree, that I 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 be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or 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 wi!! be used on this project. J 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 wj[f remain on the site at all times during
CC);(JjMwh- .3!,(/(
Owner or Contractor Signature
Date
Springfield Building Permit
3/1/2011 10:55:18AM
Page 4 of 4
SP~~~::EL~
L~(~
~ORfGON
www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2011-G0315
5755 MAIN ST
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
permitcenler@ci.springfield.or.us '
t;;]>AYMENTtYPE'/;';'
Check
15949
RECEIPT NO: 2011000371 RECORD NO: 811-SPR2011-00315 DATE: 03/01/2011
lbESCRIf~JI()N"; '. -" " ' ~- '"c,y." ,'~":'-:''''':'Y_' '.ACC.buNTZCODE" ' '. :~Mo.UNT-D,UE ,,::'1
Admin fee (10% of applicable fees) 224-00000-426605 35,00
Sign Plan Review 224-00000-425602 126.00
Si~n'or outline lighting ________________E~-O?~~_._____.______~E._____
Signs: 0 - 35 Square Feet 224-00000-425602 _____ ~qg____
Signs: 101 -150 Square Feel 224-00000-425602 160.00
Signs: 36 - 60 Square Feet 224-00000-425602 110.00
State of Oregon Surcharge (12% of applicable fees) 621-00000-215004 22.66
Technology fee (5% of permit total) 100-00000-425605 26,95
TOTAL DUE: 749,63
:PAYOR<'CASHIE'R::NMACHADO <-;,f:J;i 'COJ'i!tv\'E~TS'-' ::;;::';",'I' " ,AMOUNTPAID . t'k< ',,",cl
IMAGE KING INC 749,63
TOTAL PAID:
749,63