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Home My WebLink AboutA_Land Use Permit Master Application_170515_v1Print Form 1ieset Fm'm %lye Form PROPERTY OWNER(S) NAME: WASHINGTON FEDERAL, NA ADDRESS: 425 PIKE STREET CITY: SEATTLE, WA ZIP: 98101 TELEPHONE NUMBER: (206) 777-8228 APPLICANT (if other than owner) NAME: Steve Pulcheon COMPANY (if applicable): Taco Bell of America, LLC ADDRESS: 1 Glen Bell Way CITY: Irvine, CA ZIP: 92618 TELEPHONE NUMBER: (949) 863-3864 CONTACT PERSON NAME: Rafla Darwish COMPANY (if applicable): GPD Group (for Taco Bell) ADDRESS: 400 N. 34th Street, Suite 216 CITY: Seattle, WA ZIP: 98103 TELEPHONE NUMBER AND EMAIL ADDRESS: (206) 204-7450 PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: Taco Bell PROJECT/ADDRESS(S)ILOCATION AND ZIP CODE: 4225 NE 4th Street Renton, WA 98059 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 937400040005 EXISTING LAND USE(S): Vacant PROPOSED LAND USE(S): Taco Bell restaurant EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Commercial & Mixed Use (CMU) PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) Existing to remain EXISTING ZONING: CA Commercial Arterial PROPOSED ZONING (if applicable): Existing to remain SITE AREA (in square feet): 31,865 SF SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: N/A SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: 6,412 SF PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) N/A NUMBER OF PROPOSED LOTS (if applicable) Existing to remain NUMBER OF NEW DWELLING UNITS (if applicable): NIA H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015 PROJECT INFORMA NUMBER OF EXISTING DWELLING UNITS (if applicable): N/A SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): N/A SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): 1,856 SF SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): 1,856 SF NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): 8 TION continued PROJECT VALUE: approximately $750,000 IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): ❑ AQUIFIER PROTECTION AREA ONE ❑ AQUIFER PROTECTION AREA TWO ❑ FLOOD HAZARD AREA sq. ft. ❑ GEOLOGIC HAZARD sq. ft. ❑ HABITAT CONSERVATION sq. ft. ❑ SHORELINE STREAMS & LAKES sq. ft. ❑ WETLANDS sq. ft. LEGAL DESCRIPTION OF PROPERTY Attach legal descri tion on se arate sheet with the following information included ___:1 SITUATE IN THE QUARTER OF SECTION , TOWNSHIP _, RANGE _, IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) WASHINGTON FEDERAL, NA 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 U the authorized representative to act for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein contained and the information herewith are in all respects true and correct to the best of my knowledge and belief. ✓�I _ � �G/ May 12, 2017 Signature of Owner/R esentative Date Aa/ Zo^/+i STATE OF VdA3HtN6T6Pl ) MAiLICaDx') SS COUNTY OF4ff" ) Signature of Owner/Representative Date I certify that I know or have satisfactory evidence that 1G_E 1T44 signed this instrument and acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument. Dated Notary Public in and for the State ofiWeehiRote n mAlf-U kV MARY M BOURASSA Notary (Print): Q NOTARY PUBLIC, ARIZONA Y , MARICOPA COUNTY My CommissionExpires Ay appointment expires: February 20, 2018 3 Z—ZcD —JQ s H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015 LEGAL DESCRIPTION OF PROPERTY Attach legal descri tion on se arate sheet with the following information included ___:1 SITUATE IN THE QUARTER OF SECTION , TOWNSHIP _, RANGE _, IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) WASHINGTON FEDERAL, NA 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 U the authorized representative to act for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein contained and the information herewith are in all respects true and correct to the best of my knowledge and belief. ✓�I _ � �G/ May 12, 2017 Signature of Owner/R esentative Date Aa/ Zo^/+i STATE OF VdA3HtN6T6Pl ) MAiLICaDx') SS COUNTY OF4ff" ) Signature of Owner/Representative Date I certify that I know or have satisfactory evidence that 1G_E 1T44 signed this instrument and acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument. Dated Notary Public in and for the State ofiWeehiRote n mAlf-U kV MARY M BOURASSA Notary (Print): Q NOTARY PUBLIC, ARIZONA Y , MARICOPA COUNTY My CommissionExpires Ay appointment expires: February 20, 2018 3 Z—ZcD —JQ s H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015