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DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Planning Division
1055 South Grady Way, 6th Floor I Renton, WA 98057 1 425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Construction Industry Training Council ofo
ADDRESS: 1300 Bronson Way N
CITY: Renton STATE:
�WA
ZIP.
98057
PHONE NUMBER. -
EMAIL ADDRESS*:
❑ I prefer to receive all correspondence via US Mail.
APPLICANT (if other than owner)
NAME. Tilson (Paul Slotemaker, AICP)
COMPANY (if applicable) -
'For Seattle SMSA Limited Pi
ADDRESS:2450 NW 144th Ave
CITY_ Beaverton
STATE: ZIP:
OR 197006
PHONE NUMBER: (503) 421-2258
EMAIL ADDRESS: pslotemaker@tilsontech.com
❑ I prefer to receive all correspondence via US Mail.
CONTACT PERSON
NAME. Paul Slotemaker, AICP
COMPANY (if applicable)VeriZon, c/o TilSon
ADDRESS:2450 NW 144th Ave
CITY: Beaverton STATE: I ZIP:
OR 197006
PHONE NUMBER (503) 421-2258
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Verizon Wireless Factory Ave COW
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
1300 Bronson Way N
Renton, WA 98057
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
135230-0071
EXISTING LAND USE(S):
,Vacant lot
PROPOSED LAND USE(S):
Verizon Wireless temp COW
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
Commercial Mixed Use
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable) N/A
EXISTING ZONING:
Commercial Arterial
PROPOSED ZONING (if applicable):
No Change
SITE AREA (in square feet):
1225
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
N/A
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED: 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):
N/A
NUMBER OF EXISTING DWELLING UNITS (if applicable):
N/A
EMAIL ADDRESS:pslotemaker@tilsontech.com PROJECT VALUE:
❑ I prefer to receive all correspondence via US Mail. 1 1$25,000
*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 requested.
PROJECT INFORMATION (CONTINUED)
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL IS THE SITE LOCATED IN ANY TYPE OF
BUILDINGS (if applicable): N/A ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
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
❑ 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 NW QUARTER OF SECTION 17 TOWNSHIP 23 N, RANGE 05 _,W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Halene Sigmund , declare under penalty of perjury under the laws of the State of Washington that I
am (please check one) [a 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 are in all respects true and correct to the best of my knowledge and belief.
Q May 9, 2022 —
ignature of Owner/karesentative Date
Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that .1� Q' \ signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpos entioned in the instrument.
J),\ 1 - Qj���
Dated Notary P blic in and for the State of Washingto
I ) I I , ec,,
.
Kelli Chaney_
Notary Public
State of Washington
Commission Number 20114588
My Commission Expires
July 22, 2024
arl
My appointment expires: 0 7 L-, Z f fozcl