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HomeMy WebLinkAboutA_Master_Land_Use_Application_Form_signed_211014_v1Print Form Reset Foi _ Save Form 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: King County ADDRESS:401 5th Ave, Suite #500 CITY: Seattle STATE: ZIP: WA 98104 PHONE NUMBER: (206) 263-7891 EMAIL ADDRESS*fnelson a@7ki ngcounty.gov ❑ I prefer 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: Frances Nelson COMPANY (if applicable) King County ADDRESS:401 5th Ave, Suite #500 CITY: Seattle STATE: =48'704WA PHONE NUMBER (206) 263-7891 EMAIL ADDRESS*:tnelson@kingcounty.goy ❑ 1 prefer to receive all correspondence via US Mail. PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: Health Through Housing - Renton PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: 1150 Oakesdale Ave SW Renton, WA 98057 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 918800-0148 EXISTING LAND USE(S): R-1 Hotel PROPOSED LAND USE(S): R-2, A3, B, S-2 EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: EA PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) no change EXISTING ZONING: Co PROPOSED ZONING (if applicable): no chart e SITE AREA (in square feet): 169,280 SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: none SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: NA PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) NUMBER OF PROPOSED LOTS (if applicable) NA NUMBER OF NEW DWELLING UNITS (if applicable): 106 NUMBER OF EXISTING DWELLING UNITS (if applicable): 0 PROJECT VALUE: 100,000 *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): NA SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable):67,842 SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable):NA SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): NA NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): NA NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): 10-15 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 0 FLOOD HAZARD AREA 22,258 sq. ft. ❑ GEOLOGIC HAZARD sq. ft. ❑ HABITAT CONSERVATION sq. ft. 0 SHORELINE STREAMS & LAKES 26,708 sq. ft. ElWETLANDS 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) Anthony Wright , 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 act for a corporation (ease attach proof of authorization) and that the foregoing statements and answers herein contained and the information herewith ark in a}spectrue and correct to the best of my knowledge and belief. 'c v z Date SZJAT F W SH1N ON ) SS COUNTY OF ING ) Signature of Owner/Representative Date } I certify that I know or have satisfactory evidence that r/ • _G � 6� ������ L"J � acknowledge it to be his/her/their free and voluntary act for the uses and Purpoe Dated Nancy KodW Lee Notary Publt Stab of "fa inpion Ny Appov*m Expire w17412ortl Commiaion Nwnber 201OM Notary Publicc in Notary (Print): 4 " j - - signed this instrument and T tioned in the instrument. or the 5 e of Washington tee -- My appointment expires: '## l� /7� -2 4 f EXHIBIT "A" Legal Description Lot 4 of City of Renton Short Plat Number 016-88, recorded under Recording Number 8910279013, being a portion of Tract 13, Washington Technical Center, according to the plat thereof recorded in Volume 122 of Plats, Pages 98 through 102, inclusive, records of King County, Washington.