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HomeMy WebLinkAboutMaster Application Form (439 Renton Ave S).pdfPrlntform ,f,esct Form Sarre Fonn' DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Planning Division 1055 South Grady Way,6th Floor I Renton, WA 98057 I 425-43G-72OO www.re!tonwg.gov PROPERTY OWNER(S) NAME: Rick Miller, sarah Miller ADDRESS:43g Renton Ave s clw'Renton STATE:WA ZIP: 98057 PHoNE NUMBER: (253) 50g-3270 EMAIL ADDRESS.: 11"L.rillerg2@qmail.comE lorebrto raceive all conesoondeilce-via US Mail. APPLICANT fir other than owner) NAME: Brett wiemann COMPANY (if applicable)6rett wiemann Design LLC ADDRESS:3$5 s Edmunds st. clw'seatfle STATE: WA ZIP: 98118 PHoNE NUMBER; (206) 640,4736 EMAIL ADDRESS.:61616ry;emann@omail.com El I orebrio rceive all conesoondenEVia US Mail. CONTACT PERSON NAME' Brett wiemann COMPANY (if applicable)6wDesign LLC ADDRESS:ams s Edmunds st cltr'seattle STATE: WA ZIP: ,8118 PHoNE NUMBER (206) 6404190 EMAIL ADDRESS*:6r"thrieman n @Omai l.comlll I oretur to receive all coruesoondenEVia US Mail. PROJECT INFORMATION PROJECT OR DEVELOPMENT }.IAME: Miller Residence PROJECT/ADDRESS(S/LOCAT|ON AND ZtP CODE: +39 Renton Ave S, Renton, WA 98057 KING COUNWASSESSOR'S ACCOUNT NUMBER(S): 7221404166 EX|STTNG LAND U$E(S): SINGLE FAMILY PROPOSED ISND USE(S): SAME EXISTING COMPREHENSIVE PI.AN MAP DESIGNATION: PROPOSED COMPREHENSIVE PISN MAP DESIGNATION (if applicable) EXISTING ZONING: R8 PROPOSED ZONING (if applicable); SITE AREA (in square bet): 15.000 i SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: 0 SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED:$ PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if appliceble) NUMBER OF PROPOSED LOTS (if applicable) NUMBER OF NEW Dl /ELLING UNITS (if applicable): NUMBER OF EXISTING DWELLING UNITS (if applioable): 1 PROJECTVALUE: $410,000 LAND USE PERMIT MASTER APPLICATION *By completing the email address field the owner/applicant/contact person is opting to receive all formal notifications and project documents in digital format via email unless othenarise requested. PROJECT TNFORMATTON (CONTTNUED) SQUARE FOOTAGE OF PROPOSED RESIDENT]AL BUILDINGS (if applicable): A,Sg0 SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): 1,42s SQUARE FOOTAGE OF PROPOSED NON.RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING NON.RESIDENTIAL BUILDINGS TO REMAIN (if applicable): NET FLOORAREA ON NON-RES|DENT|AL BUILD|NGS (if applicable): NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NBA, PROJECT (if applicable): otary Public State of Washington ANTOWAN THOMAS LICENSE # 20108143 MY COMMISSION EXPIRES JUNE 2,2024 IS TI*IE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PTEASE INCLUDE SQUARE FOOTAGE (if applicable): fI nOuIrrR PRoTEcTIoN AREA oNE E nqutren PR0TEcToNAREATWo E FLOODHAZARDAREA _ sq.ft. EI oEoLoorc HAZARD _ sq.ft. E HRS|TATCONSERVATION _ sq. ft. E suonrlrNE STREAMS & LAKES _ sq.fr. fl wETLANDS _ sq.ft. LEGAL DESCRIPTION OF PROPERTY on separate sheet with the information incl qIUATE IN THE QUARTER OF SECTION TOWNSHIP - N, RANGE -_,W.M. IN THE CIfi OF RENTON, KINGCOUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP l, (Print Name/s) RICK ilflLLER , declare under penalty of perjury under the laurs of the State of Washington that I am (please check one) @ the current owner of the property involved in this application or I the authorized representative to ast for a corporation (please attach proof of authorization) and that the foregoing statemenb and answers herein contained and the information herewith are in all respects true and @rec{ to the best of my knowledge and belief. Signature of Owner/Representative Date STATE OFWASHINGTON ) couNwoF KING i t* Ieertiffthatlknoworhavesatisfactoryevidence 1611 t r'.4.'-( /\r'l l.ey - signedthisin$trumentand acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the inEtrument. l lrylzo'- . Dated W/ Notary Public in and forthe State of Washington Notary (Print): Myappointnentexpires: 7, "e- ?/ TQLY