Permit CITY OF T PERMIT #: BUP1999 -00232
, BUILDING PERMIT
DEVELOPMENT SERVICES DATE ISSUED: 7/23/99
ref I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12123 SW 69TH AVE PARCEL: 2S101AA -TTOOA
SUBDIVISION: TIGARD TRIANGLE OFFICE COMPLEX ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW FIRST: 20,535 sf N: S: E: W:
TYPE OF USE: COM SECOND: 20,535 sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: B FIRE RET? N
OCCUPANCY LOAD: 357 BASEMENT: sf AREA SEP. RATED:
STOR: 2 HT: 35 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: N MEZZ ?: N REQD SETBACKS REQUIRED
FLOOR LOAD: 100 psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 1,598,855.10
Remarks: New two -story office building - Building "A" - Shell Only -
Owner: Contractor:
TIGARD CORPORATE CENTER LP BAUGH CONSTRUCTION OREGON INC
15400 SW MILLIKAN PO BOX 14135
BEAVERTON, OR 97006 SEATTLE, WA 98114 -0135
Phone: Phone: 641 -2500
Reg #: LIC 000628
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require Pim /undslb Insp
PLCK BON 6/8/99 $2,858.70 99- 315773 Electrical Permit Required Mechanical Insp
Sprinkler Permit Required Plumb Top Out
FIRE BON 6/8/99 $1,759.19 99- 315773 Plumbing Permit Required Framing Insp
PARK BON 7/23/99 $5,586.00 99- 317083 Foot/Found Insp Insulation Insp
PRMT BON 7/23/99 $4,396.29 99- 317083 • Footing Drain Shear Wall Insp
Struc Steel Insp Gyp Board Insp
(additional fees not listed here) Reinf Steel Insp Susp Ceiing Insp
Total $15,513.76 Slab Insp Reinforced concrete final rE
Tilt -up Pnl Insp Bolts in concrete final repo,
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
ORIGINAL
Pennitee ! / /� �C >,���
Signature: .ate a Ai At_ `d . / (� c-C 5
Issued By: N AllAgPc
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Application Recd By 411 11 0 _4,
13125 SW HALL BLVD. New Construction and Additions / C Date Recd
TIGARD, OR 97223 B Date to P.E.
(503) 639 -4171 ' I L D D ate to DST Permit* i i 1 - is _ 32_
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Calied7 .
Name of Development/Project
�
Job r / i'tO Cpr , c e , 110L
Address S` Address suite Existing Building ❑ New Building jg
i �4 4 J gob Building
Bldg # 2.,
City/State Zip Data
e Tl Z « 97?'23 Existing Use of Building o
Name or Property: 1,
z
-- C h o u went Q a> Pr ao "f rvto
Property : TIGARD CORPOR ATE' CENTER P - 'VacCwt,f- —
Owner Mailing Address — Suite' Proposed Use of Building or Property:
iSODO to MI111ka I _ Offi ,
City /State Zip Phone
o ch 6L/6 —Zzoi No. Of Stories:
Occupant Name • Sq. Ft. Of Project:
Ai /A 4- 11,0 1 70
Name Occupancy Class(es)
Contractor 13a, ( tfriS C1-12.0 b
Prior to permit Mailing Address Suite Type(s) of Construction
issuance, a ccpy Po l i f 1 3 S vu ,� L � i
of all licenses I '7 fc rt 7
r-
are required if City/State Zip Phone Will this project have a Fire Suppression System?
expired in C.O.T. �1 wh t ft RgJ i q � c tf ^is j Yes No ❑
database cJ �(�(�, I Americans with Disabilities Act (ADA) Const. Cont. Board Lic.# Exp. Date ( )
000 4 Zei Valuation X 25% = $ Participation
Name IniKE P o � to Accessibility Form -7-'-'
Architect L_I S rt r f -e - C or,ri _
Valuation � 1-- -._. --
Mailing Address Suite 8� :3/(i n -
ZI SA) SA Y 10Y) /D 0 Plans Required: See Matrix for number of sets to submit
City/State Zip Phone on back
Po 1� 572.05" ZZ1-//2-1
Engineer Name M that I have read this application, that the information
V / 1 K - -� �l m the owner or authorized agent of the owner, and
Mailing Address I l in compliance with Oregon State Laws.
° 4 ‘ Date
3 .
City/ date Zip �l 1 n ✓ �ZS — f �l
Pme
U ov(' l I Link Phone
aaa- Li��
Indicate type of work: New ® Addition O /�v l e� _ /' " D (Lf , r 3
Accessory Structure 0 Foundation Only 0 `� V"� (mil ( J 70 — 49 Z Z
Repair 0 Other 0 LJ�JV • NLY / /
Description of work: e j s fi- j �
I N
6 Land U 1
L4 1,010 S jita ve. Fom4- chi (). M2, ! 5► ' mo — �� 3 Parks: Estimated # of Employees 60\9
If the above figure is not supplied at the time of a GJ�T t 1
calculate the fee based u • on the number of • arkl l , 10 RID \ • Note: Site Work Permit Application must precede or ( C-i-- c 9 0 5 (7 / 7 its
Permit Application G � o
I:ICOMNEw.DOC (DST) 5/98 o w- (%‘ F7- l / 7 59 a� i' l , ‘
C T) 98 il '5 q 4 �
q l-f t0
1
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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DISTRIBUTION TO PLANS OUT TOnDST }
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 — -- 3 (j,o,u) — —
B (New or Add) 1 1 — — 3 (j,o,w) -- —
F (New or Add or Alt.) 3 3 — — 3 (j,o,f)
M (New or Add. or Alt) 1 1 — — 2 (j,o) — —
B & M (New or Add) 1 1 — — 3 (j,o,w) — —
P (New, Add. or Alt) 2 — 2 — — 2(j,o) . —
B & M & P (New or Add.) 2 1 1 — 3 (j,o,w) 2(j,o) —
E (New, Add, or Alt) 2 — — 2 — — 2(j,o)
B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
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NOTES: KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and o = Office M = MEC
completes, updates and adds actions. f = Fire P = PLM
u =USA E =ELC
.............:................ ..............� :. :........... :. (� „�'�'s?�b�a� :rya :: R><:::: �:;:>;:: > : > : : } } :. : : }; : : : : > : : : : : : >; : :r :; w Wash. = ::::::.::.:::.:.::,::::.:.:::.,:::::...:.::.::;?.:: } :. :. :. : . : :, ?. } } : : :. }, : ? :.�... County F FPS
•
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
hmaabc.Doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP c99 '0U Z3 Z
Date Requested 1/ 3 W AM PM BLD
Location 1 1 2■ (O Suite Q MEC
Contact Person Y Ph ?L / -5 3zl PLM
Contractor Ph SWR
(BUILDING) Tenant/Owner Tt X01 ''c.1") C_ , LC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
ram
Insulation
•
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mc:
a --,
PART FAIL
BING
Post & Beam •
Under Slab
Top Out •
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab -
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reins ction RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA Approach /Sidewalk / / ' g Li ,pector Ext
Other Date
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
6�_ I `M
Date Requested I L I OO AM PM BLD
Location 1 2-123 (0 I G —
Suite -� % MEC
Contact Person TOO 1 lA Ph ELI ? SS Z/ PLM
Contractor Ph SWR
�tfILDIN Tenant/Owner � � , _ C - f) ELC
Retaining Wall ELR
Footing Access:
Foundation s �a� � . � � �� . � FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: s- G � 1 _
Slab `�- SIT
Post & Bea
Insu ation 1
Drywall Nailing Lt, ( � - .
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS AR FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA / � C
Approach /Sidewalk Date i L 4 / I nspector EXt ` / ( 7
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 1 q7 - 2 3Z
Date Requested . / -7/o0 AM � PM BLD
Location / 21 Z' ( Ave_ Suite MEC
Contact Person . Y) Ph xl9-- SS Z I PLM
Contractor Ph SWR
ILDI Tenant/Owner I E I GA ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Drywall s n Nailing j� //
,` v l J /d of � -z
� 1 /� C.J
Firewall
Fire Sprinkler
Fire Alarm / ST ? CU
Susp'd Ceiling
Roof
Misc:
PART FAIL
• I MBING
Post & Beam
Under Slab
•
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector ^ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site._
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ([ (- Z
Date Requested ACI-C AM PM BLD
q Location 1 - / Zi j tg 1 Suite MEC
Contact Person Ph PLM
Contra Ph SWR
(U UILD! Tenant/Owner 1 - r j p/Q? ELC
Re fining Wall ELR
Footing F NOT REQUESTED FPS
Foundation FOUND DURING RESEARCH
Ftg Drain INSPECTION(s) IN FILE SGN
Crawl Drain I NO INS s �) Ql �
Slab SIT
Post & Beam
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm .57 7 // U D�t,C7 c� S 7 i/( f/ /
Susp'd Ceiling t % C C)
Roof
Mis :
Fin-
- AS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk ` {.�
Other
Date 3- I t0 6 Inspector 7 - 1 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP � ���'Q���2.
Date Requested �-V1/ ` ` AM PM BLD
Location t Z 1 2 2j (O }4th Suite MEC
Contact Person eet. U 1 /\--, Ph qt./ � 2d/ PLM
Contractor Ph SWR
ILDIN Tenant/Owner ELC
- - Wall ELR
Access: FPS
PS
Ftg Drain
C 1 Drain Inspection Notes: Joan /� SGT
v� � l SIT
s & Beam � - y— /�/�
Ext Sheath /Shear S�f 6 / Ac .
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: •
Fi
.D PART FAIL
=1NG
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line �--�
ADA
Approach /Sidewalk Date g( / 1 I nspector Ext
Other /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
_ BUP t 'qg9 .0Uv) 37
Date Requested , / 2-1c ---00 AM PM BLD
Location / Z- / Z-3 A) 4 7 ' /410 Suite MEC
Contact Person / Ph 970 -z-e7 PLM
Contractor ?G A 1,60 "7 SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access: -
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam C 'S e -
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
S PART FAIL
COMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA n J�—
Approach /Sidewalk
Other Date /1 V 28-- 0 Inspector / t J Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
eu pri t Z3
DATE: 9 - 1 1 1 PLANS CHECK NO. 5 - --J Q /+
PROJECT TITLE: I l �
COUNTYWIDE (�,� '
TRAFFIC IMPACT FEE jA
WORKSHEET APPLICA T:
Klw� c,lnoevie avr- v,tkW-
(FOR NON - SINGLE FAMILY USES) MAILING ADDRESS: . 33 g
CITY/ZIP/PHONE: "T ' 7w I z2,2„1.41.
TAX MAPNO.: ZS1 //4-A _ I i oA
SITES NOADDRESS:
LAND USE CATEGORY RATE PER TRIP 1 ,Z I Z; Loo h'
RESIDENTIAL $ 189.00
BUSINESS AND COMMERCIAL $ 48.00 1
OFFICE $ 174.00 (/)t_
INDUSTRIAL $ 182.00
T TI NAL °
INSTI U O $ 79.00 ed' �
PAYMENT METHOD:
CASH/CHECK
CREDIT
BANCROFT (PROMISSORY NOTE)
INSTITUTIONAL ONLY:
DEFER TO OCCUPANCY LAN r 1 U U E CATEGORY I D SCRIP ON OF WS E TRIP RATEA(Z. 0 I WEEKEND AVG. TRIP RATE
f �
BASIS: � re-le 40 �aan ise_ J � 1 ti
' 0,- f I i ca4 3 �Vo � corns - l� c o� -� w o - s , I-{ i lQ [p
O(c
CALCULATIONS:
1f .:- SI 'fa( t t o etelerne w ee-00 am S e -tY r rat x u se G c
TIF= I,&.5.F.xIz.q0X ►1'-,00 •
1 .4 0o, Iz.wo _ 5 ,21 y, 'es nit a.s* � T c .e s_ �f9�1, i �s •
PROJECT TR ENERATION:
FEE: 4/0, %1 J 00
FOR ACCOUNTING PURPOSES ONLY
ADDITIONAL NOTES: - �` pp ( r `
oit °- ly TUB( 1 Atm D UVtQ S 1 \e koe-1 1 Vl.
Far �rfAj be uluzet bw3 (e)e Dolts)
I tAcie JACtel ROAD AMT.: ) C661 , 00
TRANSIT Al: ( (.0 . D DO
PREPARED BYra. • A n tva,_
I:TIFWKST.DOC (DST) EFF: 07 -01 -98
• DATE: / - �Q _ PLANS CHECK NO.
PROJECT TITLE:
COUNTYWIDE i tyYI COI - £ 'P ar
TRAFFIC IMPACT FEE
WORKSHEET APPLICANT:
‘1%.L/V\ x - v K 1026 - ( /L
(FOR NON - SINGLE FAMILY USES) MAILING ADDRESS:
CITY2IP/PHONE:7 w/ ,,,� coF2,_ 97261 Zu -NS3
TAX MAP NO.: - I 1 rt" -- � 1 D
SITES NOADDRESS:
LAND USE CATEGORY RATE PER TRIP I 7_12-3 S0 (..01
`
RESIDENTIAL $ 189.00
BUSINESS AND COMMERCIAL $ 48.00
I/ OFFICE $474:00
INDUSTRIAL $ 182.00
INSTITUTIONAL $ 79.00
PAYMENT METHOD:
CASH/CHECK
CREDIT
BANCROFT (PROMISSORY NOTE)
INSTITUTIONAL ONLY:
DEFER TO OCCUPANCY LAD DESCRIPTIV O WEEKDAY AVG.
"� � �_� �I � CATEGORY I����" ��I� --I TRIP RATE �Z��� WEEKEND AVG. TRIP RATE
BASIS: - RE- - CLOCattiV - tip re_. -c °e C�/IAX At) t L-� to (k� CDC ISO i 0, 5 co&cv v - �� (/77 I v�c,� o e cJt� J
/ 19 1 •
CALCULATIONS:
C IF P e s t s 4 0 ( - 1 � n P a t l y i , t 6 , 4 4 4 t 0 Y . K wee autracs - fr q, rectu X 14(4/4 use cadlaYY
Ttr_ "1", (9 X (Z ,y0 y. r'
l , o x IZ • 50 . 2:1 "1r -. M I vlu5 1 I D T cxe s = I-191 2 49S
PROJECT IP E RATION:
CFI . z� 11 X t (`61.0O - 411, 4,(Qs 11,c11.0(.0
v
FEE: 4 tot O!)
FOR ACCOUNTING PURPOSES ONLY
ADDITIONAL NOTES:
D T vi cx!Aas c Le Aavev A1. En/1 0-C- aln2 scull e - - <<L d wd(w4 -
ro� 4 f# ce�dS to I� lk2- , bwL4�s -+� f 2 i (&)E (�.t1- 0,
r'vus -t- city, -Vold IVI°vecKCVN , ROADAMT e)
TRANSIT AMT.: 6-0 0
PREPARED BY:
I:TIFWKST.DOC (DST) EFF: 07 -01 -98
• DATE: ( PLANS CHECK NO. n
PROJECT TITLE: - t V
COUNTYWIDE 1yrvkw C r Yet.1 6.1.0. A
TRAFFIC IMPACT FEE
WORKSHEET APPUCANr:
KI vtn Se)6bP,vtka2k 3 IV cr�r
(FOR NON - SINGLE FAMILY USES) MAILING ADDRESS: 31153 1 ) 1 J ' c
CITY/ZIP/PHONE: �C�C�� �VY/� . 1-72- l Zu - qq
TAX MAP NO.: Z L I IAA —T -o cI A
SITES NOADDRESS:
LAND USE CATEGORY RATE PER TRIP I 7_113 4 J (0
RESIDENTIAL $ 189.00
BUSINESS AND COMMERCIAL $ 48.00 •
/OFFICE $ 174.00
INDUSTRIAL $ 182.00
INSTITUTIONAL $ 79.00
PAYMENT METHOD:
CASH/CHECK •
CREDIT
BANCROFT (PROMISSORY NOTE)
INSTITUTIONAL ONLY:
DEFER TO OCCUPANCY LANIO7CAT I D `,'_ � N�OF OW ca WE A A /� 3I I WEEKEND AVG. TRIP RATE
BASIS: eT ( k CtJ✓�STY l G )D - 5+001) q I 0 - 1 p tti_
C.S2- A01)
CALCULATIONS:
P�aS■ S �rrr I, cl660frt(valc n x ure>z�,Cdau a,J�ra�i� 4 Irate kc x U`�e. ca /
- >'►r- = T,I�,S,�= x It 31 X 4 ' ( ly ,y J
y (,6-7a ,< rl,Vku,S i0 Tv eireAA1 _ Lot1 S
1-7 = 4 11L q ‘316 \v4,11 PROJECT • IP GENERATION:
FE, ly ► 14 it
FOR ACCOUNTING PURPOSES ONLY
ADDITIONAL NOTES:
eA - 5 °` e - duo l■ of - -1444 I,chii du ti
I or
4A4 exy s -}o be k1'zfia jf (191- oord1
kind I -cev` ROAD AMT.: 4 1 J_1'1 oD
TRANSIT AM 1)Z 00
B
PREPARED : iVI 0.G„
I:TIFWKST.DOC (DST) EFF: 07 -01 -98
DATE: . „ C/ _ G� PLANS CHECK NO.
PROJECT TITLE: J
COUNTYWIDE I c-∎ Covkare T6urK ei4
TRAFFIC IMPACT FEE
WORKSHEET APPLICANT
1� i rn AoPan e 6. IV1eev-
(FOR NON - SINGLE FAMILY USES) MAILING ADDRESS: Vi .a)t) �,.(� -7 2
CITY/ZIP/PHONE:� - ,^� i`- /� / 1 7.22_ L/i ✓„
TAX MAP NO.: z IAA - } - loo
SITES NO.ADDRESS: / ` t
LAND USE CATEGORY RATE PER TRIP I)- (2-j ZI) (.
RESIDENTIAL $ 189.00
BUSINESS AND COMMERCIAL $ 48.00
OFFICE $ 174.00 4 1 `61- -I ° eg-e ick.) 1-1-19
INDUSTRIAL $ 182.00
INSTITUTIONAL $ 79.00
PAYMENT METHOD:
CASH/CHECK
CREDIT
BANCROFT (PROMISSORY NOTE)
INSTITUTIONAL ONLY:
DEFER TO OCCUPANCY IAN i USE CATEGORY 1 r CR O$I G O E I W TRIP EEKDAY RATE 1I A� G. O•�I WEEKEND AVG. TRIP RATE
I r I l I
BASIS: �� � t/i ivIoteeuIa- e e. 1- 1-1q.
q. rr
"(� ,��� cd vYO S it) Coy\ -kir wck Q *a'o s-kbcL , L11,0700 �t tt c.2
tot A
CALCULATIONS: x ( y
1 f t ` P Me/14(v oy\ x w�e av�• -Irtt' ra & a - ��.J
10 ?( $
i 1 I . o7o x 1 (. , 1 = 10 0. $STr>' rt k V I I A s -* 1 D I r OCOAG _ 1, ys j s
(,s 9.46s - Try X I D 14 IZI��L.�ID �� (2_1,14 ( °O PROJECT�RIQGLNERATION:
FEE4 1 � ( I p(pl' Z aD
FOR ACCOUNTING PURPOSES ONLY
ADDMONAL NOTES:
I b Y,' cor -5 - da.wlo< AAA/ e-A4 -�a
atoll r -k i creoUs -b be 04-i It , (&)(2 l91' -Dol ti mus
e kt75 -r IY»lX Ir7UJL i v dkm . ROAD AMT.:. 111 )6 z too
TRANSIT AMT.: $ !� /C.v� p0
PREPARED BY: 6. rJ
I:TIFWKST.DOC (DST) EFF: 07 -01 -98
•