HomeMy WebLinkAboutA_State_Farm_TI_LU Master Application_v1Print Farm Reset Form ' Save Farris
DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT r�
Planning Division
1055 South Grady Way, 6th Floor I Renton, WA 98057 1 425-430-7200
www.rentonwaxov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME.: Evan Silvers
ADDRESS:3418 SE 6th St
CITY:IZentOn STATE; I ZIP:
IWA 198058
PHONE NUMBER: (509) 952-2425
EMAIL ADDRESS•silversejs2009@gmaiLcom
❑ 1 refer to receive all correspondence via US Mail.
APPLICANT (if other than owner)
NAME: Calvin Tam
COMPANY (if applicable) -
Tam Design
ADDRESS:10040 Sand Point Way NE
CITY Seattle
STATE:
�WA
ZIP:
198125
PHONE NUMBER: (206) 240-3321
EMAIL ADDRESS•salvint006@gmaiLcom
❑ 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:
State Farm TI
PROJECTIADDRESS(S)ILOCATION AND ZIP CODE:
3418 SE 6th ST
Renton, WA 98058
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
512690-0326
EXISTING LAND USE(S):
Small-scale convenience retail/commercial
PROPOSED LAND USE(S):
No change from existing
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
EXISTING ZONING:
CN
PROPOSED ZONING (if applicable):
CN
SITE AREA (in square feet):
5,989 S.F.
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
None
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED: None
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NUMBER OF PROPOSED LOTS (if applicable)
N/A existing lot
NUMBER OF NEW DWELLING UNITS (if applicable):
0
NUMBER OF EXISTING DWELLING UNITS (if applicable):
2
PROJECT VALUE:
$90,000
'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
BUILDINGS (if applicable): No new proposed
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):2 189 S.F.
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): No new proposed
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): 1,970 S.F.
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable): No new proposed
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if appliczt ft
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.•
❑ GEOLOGIC HAZARD
sq. f-
❑ HABITAT CONSERVATION
sq• n•
❑ 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 SE QUARTER OF SECTION 16 TOWNSHIP 23 N, RANGE 5 _,W.M. IN THE CITY
OF RENTON. KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
1, (Print Namels) Evan Silvers , declare under penalty of perjury under the laws of the State of Washington that
am (please check one) 0 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 ryes a and correct to the best of my knowledge and belief.
z /l,7j2z-
Signature of Owner/Representative I Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
) Ss
COUNTY OF KING )
I certify that I know or have satisfactory evidence that C Vn n S L jers signed this instrument and
acknowledge it to be hislherltheir free and voluntary act for the uses and purpose mentioned in the instrument.
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Dated Notary Public in and for the State of Washington
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