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Home My WebLink AboutA_Master_Land_Use_Form_180305_v2.pdfPrint Form Reset Form Save Form DEPARTMENT OF COMMUNITY CITY OF AND ECONOMIC DEVELOPMENT _��0 Planning Division LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME: John C. Radovich LLC & Todd Gardner ADDRESS: 2835 82nd Ave SE, Ste S-1 & 4512 Talbot Rd S CITY: Mercer Island & ZIP: 98040 & Renton 98055 TELEPHONE NUMBER: (206) 910-7236 (425) 226-7920 APPLICANT (if other than owner) NAME: Alex Bunn COMPANY (if applicable): Weatherly Inn ADDRESS: 606 Columbia St NW, Ste #101 CITY: Olympia ZIP: 98501 TELEPHONE NUMBER: (360) 943-3241 CONTACT PERSON NAME: Frank Durocher COMPANY (if applicable): RJ Development ADDRESS: 401 Central St SE CITY: Olympia ZIP: 98501 TELEPHONE NUMBER AND EMAIL ADDRESS: (360) 528-3343 1 PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: Weatherly Inn Renton PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: 4500 Talbot Rd S Renton, WA 98055 Todd Gardner's (neighbor at 4512 Talbot Rd S) participation is for only the access driveway portion of the proposal. KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 3123059067 3123059094 EXISTING LAND USE(S): Vacant PROPOSED LAND USE(S): Assisted Living & Memory Care EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Commercial Mixed Use PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) Commercial Mixed Use EXISTING ZONING: Commercial Office (CO) PROPOSED ZONING (if applicable): Commercial Office CO SITE AREA (in square feet): 202476 SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: 0 SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: 2920 PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) 24.95 NUMBER OF PROPOSED LOTS (if applicable) 2 NUMBER OF NEW DWELLING UNITS (if applicable): 116 Units of AL & 30 beds of MC in 19 Units H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015 PROJECT INFORMAT NUMBER OF EXISTING DWELLING UNITS (if applicable): N/A SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): AL: 120,690 SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): MC: 22,589 SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): MC: 22,589 NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): 40 ION continued PROJECT VALUE: $27,800,000 IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): ❑ AQUIFIER PROTECTION AREA ONE ❑ AQUIFIER 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 description on separate sheet with the following information included SITUATE IN THE NE QUARTER OF SECTION 31 , TOWNSHIP 23N , RANGE 5E , IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) CJ , declare under penalty of perjury under the laws of the State of Washington that I am (please check one) Lo the current owner of the property involved in this application or Q the authorized representative to a t for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein contained and tF}e i formation herewith are in all respects true and correct to the best of my knowledge and belief. Signature of Ow entative Date Signature of Owner/Representative Date STATE OF WAST I} ETON ) (% ) SS COUNTY OF KING ) I certify that I know or have satisfactory evidence that Jlfk W ' "YL�rG�' � signed this instrument and acknowledge it to be his/her/their free and voluntary act for the uses and purpoOmmentioned in the instrument. 22 VK��\��\111�t'�tl VER, [, Dated , ZZ Zr ca i _+ 0 '. i 1� Notary (Print): ��p� +h�8a19 My appointment expires: ��i 2 H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015 iiiiiiiiiiir , krM4' DEPARTMENT OF COMMUNITYCITY OF AND ECONOMIC DEVELOPMENT %!mnton Planning Division LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME: John C. Radovich LLC & Todd Gardner ADDRESS: 2835 82nd Ave SE, Ste S-1 & 4512 Talbot Rd S Mercer Island & 98040 & CITY: Renton ZIP' 98055 TELEPHONE NUMBER: (206) 910-7236 (425) 226-7920 APPLICANT (if other than owner) NAME: Alex Bunn COMPANY (if applicable): Weatherly Inn ADDRESS: 606 Columbia St NW, Ste #101 CITY: Olympia ZIP: 98501 TELEPHONE NUMBER: (360) 943-3241 � CONTACT PERSON r NAME: Frank Durocher COMPANY (if applicable): RJ Development ADDRESS: 401 Central St SE CITY: Olympia ZIP: 98501 TELEPHONE NUMBER AND EMAIL ADDRESS: (360) 528-3343 1 PROJECT INFORMATION PROJECTOR DEVELOPMENT NAME: Weatherly Inn Renton PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: 4500 Talbot Rd S Renton, WA 98055 Todd Gardner's (neighbor at 4512 Talbot Rd S) participation is for only the access driveway portion of the proposal. KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 3123059067 3123059094 EXISTING LAND USE(S): Vacant PROPOSED LAND USE(S): Assisted Living & Memory Care +I EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Commercial Mixed Use PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) Commercial Mixed Use EXISTING ZONING: Commercial Office (CO) PROPOSED ZONING (if applicable): Commercial Office (CO) SITE AREA (in square feet): 1 202476 I SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: 0 SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: f 12920 PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) `I 24.95 NUMBER OF PROPOSED LOTS (if applicable) 2 NUMBER OF NEW DWELLING UNITS (if applicable): 116 Units of AL & 30 beds of MC in 19 Units H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015 PROJECT INFORMA7 NUMBER OF EXISTING DWELLING UNITS (if applicable): N/A SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): AL: 120,690 SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): MC: 22,589 SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): MC: 22,589 NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): 40 ION continued PROJECT VALUE: $27,800,000 IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): ❑ AQUIFIER PROTECTION AREA ONE ❑ AQUIFIER 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 iAttach legal description on separate sheet with the following information included SITUATE IN THE NE QUARTER OF SECTION 31 , TOWNSHIP 23N , RANGE 5E , IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) dRclara i indrar nanalfv of nark in, i inriar +he 1—aic .,f +he C+�+e ^f 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. Signature of Ownerl'Representative Da e STATE OF WASHINGTON ) ) SS COUNTY OF KING ) I certify that I know or have satisfactory evidence that / acknowledge it to �be his/her/their free and voluntary act for the uses Da ed Notary Signature of Owner/Representative Date .L_ signed this instrument and ed in the instrument. in and r the State of NOTARY = � �i My appointment expires: PUBLIC t' 142 �p�p� 2 �i FOf I SH�NG )ata\�'blar�n �s\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015