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HomeMy WebLinkAboutA_Land_Use_Master_Application_191114_v1DEPARTMENT OF COMMUNITY VI£., AND ECONOMIC DEVELOPMENT -,, Planning Division 1055 South Grady Way, 6th Floor I Renton, WA 98057 425-430-7200 � vvvw.rentonwa.gov LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME Duvall & 17th L.LC ADDRESS 4111 E. Madison St #438 CITY: SeattleT TE W�12 -- — -.... _.... ........ PHONE NUMBER: 206.323.5544 EMAIL ADDRESS':jerrolds@comcast.net ❑ I prefer to receive all correspondence Via US Mail. APPLICANT (if other than owner) NAME: Ben Hruska COMPANY (if applicable):Broderlck Architects -- -- -_-. __..— ADDRESS: 55 S Atlantic St #301 CITY Seattle ffATE. 134 PHONE NUMBER'. 206.682.7525 EMAIL ADDRESS•:ben@broderickarchitects.com ❑I prefer to receive all correspondence via US Mail. CONTACT PERSON NAME: Same as Applicant COMPANY (if applicable). ADDRESS: CITY. STATE: ZIP: PHONE NUMBER EMAIL ADDRESS'. ❑ I prefer to receive all correspondence via US Mail PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: Dental Office Building PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE 1625 Duvall Ave NE Renton, WA 98059 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 516970-0129 EXISTING LAND PE(S): Single Family Home/Office PROPOSEDLAND USE(S): Dental Office Building G€A XI TING COMPREHENSIVE PI. AN MAP DESIGNATION. ommerclal Arterial PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) GSATommercla� Arterial PROPOSED ZONING (if applicable). SITE AREA (in square feel): ©,417 st SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: iv SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED. 426 Sf PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) NUMBER OF PROPOSED LOTS (if applicable) NUMBER OF NEW DWELLING UNITS (if applicable). NUMBER OF EXISTING DWELLING UNITS (if applicable) PROJECT VALUE: 500,000 *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 requesters. PROJECT INFORMATION (CONTINUED) SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): 5463 Sf (IBC) SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): 0 NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): 3000 sf (Enclosed & Office Areas) NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): 3-6 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. ❑ 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 bW QUARTER OF SECTION 03 TOWNSHIP 23 N, RANGE 05 _,W.M. IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) Zirto ll e�>'t r w{- , 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 answers herein contained and the information herewith arein all respec�tr�nd corrp�ct to the best of my knowledge and belief. / ,/ Z?—F ignature of Own /Re (esentative 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 m an a State of Washm on Z'--- /? L. Notary (Print): p LEILA ::I RRAY My appointment expires: NOTLIC STATE ONGTON My ommissan ember 9, 2020