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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: Luka Hocevar
ADDRESS: 332 Burnett Ave S
CITY: Renton
STATE:
STATE:
ZIP:
98057
PHONE NUMBER: (425) 276_5721
EMAIL ADDRESS+:luka@hocevarperformance.com
❑ I prefer to receive all correspondence via US Mail.
APPLICANT (if other than owner)
NAME: Trenise Williams
COMPANY (if applicable): Renton Residents for Chang
ADDRESS:2059 SE 8th Dr
CITY: Renton
STATE:
WA
P:
0055
PHONE NUMBER: (901 ) 264-4155
EMAIL ADDRESS:trenisewllliam55@gmail.Com
❑ I prefer to receive all correspondence via US Mail.
CONTACT PERSON
NAME:
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:
IBLM mural
PROJECTIADDRESS(S)ILOCATION AND ZIP CODE:
332 Burnett Ave S
Renton, WA 98057
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
723150230008
EXISTING LAND USE(S):
Retail Store
PROPOSED LAND USE(S):
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
EXISTING ZONING:
CD
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
12000
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
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:
$10,000
*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 SE QUARTER OF SECTION 18 TOWNSHIP 23 N, RANGE 05 ,W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Namels) 44)CArZy/1,Q , declare under penalty of perjury under the laws of the State of Washington that
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 are in all re true and correct to the best of my knowledge and belief.
T— 0
Signatu a of O er&ep sentative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
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.
— — _2 - Lo 2
Dated
'DIANE M DOBSON
NOTARY PUBLIC
STATE OF WASHINGTON
COMMISSION EXPIRES
MARCH 19, 2022
ry Public in'and * ihe)State of Washington
�IAN Ef
Notary (Print):
My appointment expires: rf -4024�:—