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A_Master_Land_Use_Form_181111_v1
Print Form Reset Form Save Form DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT Planning Division 1055 South Grady Way, 6th Floor I Renton, WA 980571425-430-7200 www.rentonwa.gov LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME:SIN DENH C+KUEN SHING PANG ADDRESS:912 N 37TH ST CITY: RENTON ZIP: 98056 TELEPHONE NUMBER: (206) 334-5801 APPLICANT (if other than owner) NAME: COMPANY (if applicable): ADDRESS: CITY: ZIP: TELEPHONE NUMBER: CONTACT PERSON NAME: PETER PANG COMPANY (if applicable): ADDRESS:912 N 37TH ST CITY: RENTON ZIP: 98056 TELEPHONE NUMBER AND EMAIL ADDRESS: (206) 334-5801 peter.pang28@yahoo.com PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: PANG RESIDENCE PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: 912 N 37TH ST, RENTON, WA 98056 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 889960-0060 EXISTING LAND USE(S): SINGLE FAMILY PROPOSED LAND USE(S): SINGLE FAMILY EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: CITY OF RENTON PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) N/A EXISTING ZONING: R-6 PROPOSED ZONING (if applicable): N/A SITE AREA (in square feet): 5,295 SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: N/A SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: N/A PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) N/A NUMBER OF PROPOSED LOTS (if applicable) N/A NUMBER OF NEW DWELLING UNITS (if applicable): 1 H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/201 PROJECT INFORMAT NUMBER OF EXISTING DWELLING UNITS (if applicable): 0 SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): 2,095 SF SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): N/A SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): N/A NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): N/A ION (continued PROJECT VALUE: $750,000 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. ❑ GEOLOGIC HAZARD sq. ft. 0 HABITAT CONSERVATION sq. ft. ❑ SHORELINE STREAMS & LAKES sq. ft. ❑ WETLANDS sq. ft. J LEGAL DESCRIPTION OF PROPERTY Attach legal description on separate sheet with the following information included SITUATE IN THE NW QUARTER OF SECTION 32 , TOWNSHIP 24 , RANGE 5 IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) f�F SHFNG �'o`NG- — i 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 Q 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 h with are in all respects true and correct to the best of my knowledge and belief. Y1-2-71id Signature of Owner/Representative Date Signature of Owner/Representative Date STATE OF WASHINGTON ) ) SS COUNTY OF KING ) I certify that I know or have satisfactory evidence that DC V� f` `C_ S t ✓N signed this instrument and acknowledge it to be his/her/their free and voluntary act�he uses and purpose mention a instrument. Dated Notary Pubis , `�� �r • •;;gS10N F� • � i • rr� °i9 Notary (Print): oO `�N•. of Washington NOTARY PUBLIC = My appointment expires: ©' V -A 16 ;O ` — 0F 2 WAS`�'���, H:\CED\Data\Forms-f6irfol8t#§\I�b)f-Help Handouts\Planning\Master Application.doc Rev: 10/2017