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DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT L
Planning Division
1055 South Grady Way, 6th Floor I Renton, WA 98057 1425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Tejpal S. and Rupinder K. Hansra
ADDRESS: 5507 NE 1st PI
CITY: Renton
STATE:
IWA
ZIP:
198059
PHONE NUMBER: (360) 527-1400
EMAIL ADDRESS*:paulhansra@hotmail.Com
El I refer to receive all correspondence via US Mail.
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY:
STATE:
ZIP:
PHONE NUMBER:
EMAIL ADDRESS':
❑ I prefer to receive all correspondence via US Mail.
CONTACT PERSON
NAME:
Tejpal (Paul) S. Hansra
COMPANY (if applicable):
ADDRESS: 5507 NE 1st PI
CITY: Renton
STATE:
IWA 198059
ZIP:
PHONE NUMBER (360) 527-1400
EMAIL ADDRESS-:paulhansra@ hotmail.Com
❑ 1 prefer to receive all correspondence via US Mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Hansra Covered Patio Variance
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
5507 NE 1 st PI, Renton, WA 98059
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
666450-0090
EXISTING LAND USE(S):
SINGLE FAMILY RESIDENCE
PROPOSED LAND USE(S):
SINGLE FAMILY RESIDENCE
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
RESIDENTIAL LOW DENSITY
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable) N/A
EXISTING ZONING:
R-4
PROPOSED ZONING (if applicable):
N/A
SITE AREA (in square feet):
470 SOFT Covered Patio
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):
1
PROJECT VALUE:
$50,000
*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):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable):
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if applicable):
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 QUARTER OF SECTION , TOWNSHIP N, RANGE _,W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Tejpal S. and Rupinder K. Hansra declare under penalty of perjury under the laws of the State of Washington that I
am (please check one) Q 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 andbelief.
-11-2019 5-11-2019
Sig6wa of Owner/Representative Date at e f p ntative Date
STATE OF WASHINGTON )
SS
COUNTY OF KINGM94,5)
I certify that I know or have satisfactory evidence that TCTX Z.
3L4 �Pr�lO signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose m nfioned in the instrument.
4�- 1,, / 20
Dated
MARY JANE P MUNOZ
NOTARY PUBLIC
STATE OF WASHINGTON
COMMISSION EXPIRES
MARCH 7, 2022
Notary Public in and for the State of Washington
11,00t,J�� P. M vao
Notary (Print):
My appointment expires:
Legal Description of Property
Lot 9, Parklane Court, according to the plat thereof recorded in Volume 240 of Plats, pages 15
through 18, records of King County, Washington.
Situate in the NE Quarter of Section 15, Township 23 N, Range 05, W.M. in the City of Renton,
King County, Washington.