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DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Planning Division
1055 South Grady Way,6th Floor I Renton,WA 98057 I 425-430-7200
,www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME:c.\r\Od-\~s D\.,JQ.\'I)\S5 on ~V\o...\~,,~
~(JI
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Rose Cafe Temporary Use Permit
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
226 Wells Ave S
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
7231501165
EXISTING LAND USE(S):
Retail
PROPOSED LAND USE(S):
Retail/Cafe
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
Commercial Mixed Use (CMU)
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
EXISTING ZONING:
CD
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
5750
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NUMBER OF PROPOSED LOTS (if appl,icable)
NUMBER OF NEW DWELLING UNITS (if applicable):
NUMBER OF EXISTING DWELLING UNITS (if applicable):
PROJECT VALUE:
ADDRESS:
L;
*By completing the email address field the owner/applicant/contact person is opting to receive all formal notifications
and project documents in digital format via email unless otherwise requested.
CITY:
~\-c,
PHONE NUMBER:l{
EMAIL ADDRESS*:
I refer to receive all corres ondence via US Mail.
APPLICANT (if other than owner)
NAME:K tt+re.tY\e\t~
COMPANY (if applicable):\"K
ADDRESS:
2
PHONE NUMBER:
'()t:0
EMAIL ADDRESS*:\<a -+retVleLlv'W)<ti1{?~tnt1..(\.e41t'l')o I refer to receive all corres ondence via US"IV1ail.
CONTACT PERSON
NAME:l'S ve...
COMPANY (if applicable):
ADDRESS:
ZIP:CITY:
PHONE NUMBER
EMAIL ADDRESS*:o I refer to receive all corres ondence via US Mail.
I PROJECT INFORMATION (CONTINUED)I
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL IS THE SITE LOCATED IN ANY TYPE OF
BUILDINGS (if applicable):ENVIRONMENTALLY CRITICAL AREA,PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):D AQUIFER PROTECTION AREA ONE
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL D AQUIFER PROTECTION AREA TWO
BUILDINGS (if applicable):D FLOOD HAZARD AREA __sq.ft.
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
5750 sq.ft.BUILDINGS TO REMAIN (if applicable):0 GEOLOGIC HAZARD
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if D HABITAT CONSERVATION __sq.ft.
applicable ):
D SHORELINE STREAMS &LAKES __sq.ft.
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if applicable):D WETLANDS __sq.ft.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE SW QUARTER OF SECTION~,TOWNSHIP ~N,RANGE ~_,W.M.IN THE CITY
OF RENTON,KING COUNTY,WASHINGTONIA_F_F_ID_A_V_IT__O_F_O_W_N_E_R_S_H_IP I
S~~0L...JL-ol
I,(Print Name/s),declare under penalty of perjury under the laws of the State of Washington that I
am (please check one)0 the current owner of the property involved in this application or 0 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 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 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 of Washington
Notary (Print):
My appointment expires:
-St.cu»~fES C1'£jf.CfE
230 Wells Ave.S.
Renton,WA 98057
jf.wr!IQVfES d ~s?fO(}l.j,.rrIOfNS ~
Phone:425.226.8427
Fax:425.687.8077
stchaspl@aol.com
-August 29,2019
TO WHOM IT MAY CONCERN:
N\y-bro-ther~ohn E>i vetbi-ss-anrl-I-;-ehurtes-G.-E7ive-fhissare comp I ete-iy-<'lw<'ll"e-of-K-ati-e-----
Newman's remodeling and prep?ration for her new business.We are behind her efforts
and we will help as needed.
If you have questions or concerns,please don't hesitate to contact me at
425-226-8427.
Sincerely,
~-,-,.-
Charles G.Divelbiss
Building/Property Manager
I