HomeMy WebLinkAboutA_MasterApp_240528_v1CITY OF RENTON I PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Duy Vu
MAILING ADDRESS: 2123 Shattuck Place S, Renton, WA 98055
n I prefer to receive all correspondence via US mail.
APPLICANT (if other than owner)
PHONE:
EMAIL: duyvul8@yahoo.com
NAME: Tracy Brink COMPANY (if applicable):
PHONE: 206-779-6149 EMAIL: tlb.arch@gmail.com
MAILING ADDRESS: 441 Burnett Ave S
I prefer to receive all correspondence via US mail.
CONTACT PERSON
NAME: Same as applicant COMPANY (if applicable):
PHONE: EMAIL:
MAILING ADDRESS:
I prefer to receive all correspondence via US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME: Vu Residence
PROJECT/ADDRESS(ES) AND PARCEL NUMBERS: 855740-0005
EXISTING LAND USE(S): single family residence PROPOSED LAND USE(S): 110 Change
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Residential Medium Density
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):
EXISTING ZONING: R-6 PROPOSED ZONING: no Change
SITE AREA (in square feet): 9534 s f.
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: not applicable
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable): not appliCable
NUMBER OF PROPOSED LOTS (if applicable): not applicable
NUMBER OF NEW DWELLING UNITS (if applicable): not applicable
NUMBER OF EXISTING DWELLING UNITS (if applicable): One PROJECT VALUE: $70,000
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): 429 s.f. proposed addition
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): 2508 s.f. existing floor area
rentonwa.eov/permitservices I planninecustomerservice@rentonwa.aov 142S-430-7294 10/24/2023 1 Page 1 of 2
LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): not applicable
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): not applicable
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): not applicable
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): not applicable
IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable):
❑ AQUIFER PROTECTION AREA ONE ❑ AQUIFER PROTECTION AREA TWO
❑ FLOOD HAZARD AREA SQ. FT. ❑ SHORELINE STREAMS & LAKES SQ. FT.
12 GEOLOGIC HAZARD 6775 s.£ SQ. FT. ❑ WETLANDS SQ. FT.
❑ HABITAT CONSERVATION SQ. FT,
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE SE QUARTER OF SECTION 19 TOWNSHIP 23 N, RANGE 5
W.M IN THE CITY OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) V U y y C/ , declare under penalty of perjury under the laws of the State of
Washington that I am (please check one) the current owner of the property involved in this application or the
authorized representative to act for a corporation (please attach proof of authorization) and that the foregoing
statements and ans ers herein contained and the information herewith are in all respects true and correct to the best
of my knowle g n beljpf�
Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING
Signature of Owner/Representative Date
I certify that I know or have satisfactory evidence that Dvstli Vv signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
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Dated
ZEPHYR L GUTHRIE
NOTARY PUK CMOOMii
STATE OF WASHINGTON
MYCOAIM>UMEXPIRES
124H4$
Public in and for the State of Washington
Notary
My appointment expires:
rentonwa.eoy/permitseryices I planninecustomerservice@rentonwa.¢ov 1 425-430-7294 10/24/2023 1 Page 2 of 2