HomeMy WebLinkAboutA_Master_Land_Use_Form_180305_v2Print Form Reset Form Save Form
DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT 0
Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: John C. Radovich LLC & Todd Gardner
ADDRESS: 2835 82nd Ave SE, Ste S-1 &
4512 Talbot Rd S
CITY: Mercer Island & ZIP: 98040 &
Renton 98055
TELEPHONE NUMBER: (206) 910-7236
(425) 226-7920
APPLICANT (if other than owner)
NAME: Alex Bunn
COMPANY (if applicable): Weatherly Inn
ADDRESS: 606 Columbia St NW, Ste #101
CITY: Olympia ZIP: 98501
TELEPHONE NUMBER: (360) 943-3241
CONTACT PERSON
NAME: Frank Durocher
COMPANY (if applicable): RJ Development
ADDRESS: 401 Central St SE
CITY: Olympia ZIP: 98501
TELEPHONE NUMBER AND EMAIL ADDRESS:
(360) 528-3343
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Weatherly Inn Renton
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
4500 Talbot Rd S
Renton, WA 98055
Todd Gardner's (neighbor at 4512 Talbot Rd S) participation is
for only the access driveway portion of the proposal.
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
3123059067
13123059094
EXISTING LAND USE(S):
Vacant
PROPOSED LAND USE(S):
Assisted Living & Memory Care
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
Commercial Mixed Use
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
Commercial Mixed Use
EXISTING ZONING:
Commercial Office (CO)
PROPOSED ZONING (if applicable):
Commercial Office CO)
SITE AREA (in square feet):
202476
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
0
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
2920
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
24.95
NUMBER OF PROPOSED LOTS (if applicable)
2
NUMBER OF NEW DWELLING UNITS (if applicable):
116 Units of AL & 30 beds of MC in 19 Units
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015
PROJECT INFORMAT
NUMBER OF EXISTING DWELLING UNITS (if applicable):
N/A
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): AL: 120,690
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): N/A
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): MC: 22,589
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): N/A
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable): MC: 22,589
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable): 40
ION continued
PROJECT VALUE:
$27,800,000
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFIER PROTECTION AREA ONE
❑ AQUIFIER 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 NE QUARTER OF SECTION 31 , TOWNSHIP 23N , RANGE 5E , IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) 6 L/ , 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 a t for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein
contained and tl i formation herewith are in all respects true and correct to the best of my knowledge and belief.
Signature of Ow entative Date Signature of Owner/Representative Date
STATE OF WASH,F ICTON )
f% ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that �h W ' 4 w kC�-ifV r" signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpoiA mentioned in the instrument.
.
Dated � A
ZZ
—mil- ` • •
Notary (Print):
IN appointment expires:
t�
2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015
Pant Form Reset Form Save Form
DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT
Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: John C. Radovich LLC & Todd Gardner
ADDRESS: 2835 82nd Ave SE, Ste S-1 &
4512 Talbot Rd S
Mercer Island & 98040 &
CITY: Renton ZIP' 98055
TELEPHONE NUMBER: (206) 910-7236
(425) 226-7920
APPLICANT (if other than owner)
NAME: Alex Bunn
COMPANY (if applicable): Wppnthprly Inn
ADDRESS: 606 Columbia St NW, Ste #101
CITY: Olympia ZIP: 98501
TELEPHONE NUMBER: (360) 943-3241
CONTACT PERSON
NAME: Frank Durocher
COMPANY (if applicable): RJ Development
ADDRESS: 401 Central St SE
CITY: Olympia ZIP: 98501
TELEPHONE NUMBER AND EMAIL ADDRESS:
(360) 528-3343
1
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Weatherly Inn Renton
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
4500 Talbot Rd S
Renton, WA 98055
Todd Gardner's (neighbor at 4512 Talbot Rd S) participation is
for only the access driveway portion of the proposal.
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
A 4 AAACAA/?7
3123059094
EXISTING LAND USE(S):
Vacant
PROPOSED LAND USE(S):
Assisted Living & Memory Care
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
Commercial Mixed Use
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
Commercial Mixed Use
EXISTING ZONING:
Commercial Office (CO)
PROPOSED ZONING (if applicable):
Commercial Office (CO
SITE AREA (in square feet):
202476
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
0
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
2920
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
24.95
NUMBER OF PROPOSED LOTS (if applicable)
2
NUMBER OF NEW DWELLING UNITS (if applicable):
i 4 G I Ir:4- -4 A l O 7/1 4...A \ Af% : A 1 I-:&-
1 1 V VI IIaV VI I •V K VV VVVV VI IYIV 111 1 V VI IIaV
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015
PROJECT INFORMAT
NUMBER OF EXISTING DWELLING UNITS (if applicable):
N/A
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): AL: 120,690
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): N/A
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): MC: 22,589
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): N/A
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable): MC: 22,589
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable): 40
ION continued
PROJECT VALUE:
$27,800,000
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFIER PROTECTION AREA ONE
❑ AQUIFIER 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 NE QUARTER OF SECTION 31 , TOWNSHIP 23N , RANGE 5E , IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) ,+ ` fel /l�C/� //G , declare under penalty of perjury under ttig laws of the State of
Washington that I am (please check one) ' the current owner of the property involved in this application orthe 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 OwnerlRepresentative Da e
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that . r // 1
acknowledge it to be his/her/their free and voluntary act for the used
Dafed Notary
Signature of Owner/Representative Date
�! signed this instrument and
fed in the instrument.
in and f¢r the State of Washington
c�orARy = d9/� �i
My appointment expires:
PUBLIC t'
142 �p�p� 2
FOF WASHk%'A ��`•
)ata s\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015