Fillable Zoning Permit Application Planning Department Innovative - Responsive (City of Kirkland)

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Zoning Permit Application Planning Department Innovative - Responsive (City of Kirkland)

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Page 1 of 4
DevSvcs-PMC-2.0-20160316
Innovative - Responsive - Professional
Complete this form to submit at City Hall. Or, use mybuildingpermit.com to submit your application entirely online.
Zoning Permit
Application
Planning Department
This permit application packet is designed to obtain all the information necessary to allow the City to make a well
informed decision on your application. Please refer to the attached application checklist to determine the materials
which must be submitted to complete your application. All application materials are considered public information.
Your application will be evaluated on the basis of the information you provide, the criteria listed in the pertinent section
of the Zoning Code, the Kirkland Comprehensive Plan, other City regulatory ordinances, inspection of the property, as
well as public comments.
YOU ARE ENCOURAGED TO MEET WITH A PLANNER FROM THE DEPARTMENT OF PLANNING AND COMMUNITY
DEVELOPMENT PRIOR TO AND DURING PROJECT DESIGN TO DISCUSS PROJECT COMPLIANCE WITH CITY
REGULATIONS. PRIOR TO APPLICATION SUBMITTAL, YOU MUST MEET WITH A PLANNER TO OBTAIN GUIDANCE ON
THE APPLICATION MATERIALS YOU MUST SUBMIT.
Copies of City documents such as the Comprehensive Plan, Zoning Ordinance and Subdivision Ordinance are available at
the Planning and Building Department in City Hall, 123 Fifth Avenue and at the Kirkland Public Library, 308 Kirkland
Avenue.
To purchase the Comprehensive Plan or Zoning Ordinance, call Code Publishing Company at 206-527-6851.
City ordinances can also be found on-line at www.kirklandwa.gov.
NOTE: Information provided by the Planning and Building Department represents a preliminary, qualified assessment
which is based on the information provided by the applicant/contact person. More detailed technical review of
a specific development permit application may disclose additional substantive or procedural requirements.
Furthermore, in the case of a discretionary zoning permit, the role and the authority of the City staff is advisory
only. A final decision on such a permit can only be made, after public comment and/or a public hearing by the
Planning and Building Director, Hearing Examiner, or City Council, depending upon the type of permit.
Page 2 of 4
DevSvcs-PMC-2.0-20160316
PROCESS
Process I Process IIA Process IIB Process IV Modification
APPLICANT
Name
Address
City State Zip Code
Daytime #
Alternate #
Email
Note: If applicant is not property owner, he/she must be authorized as agent (see page 2).
OWNER
Name
Address
City State Zip Code
Daytime #
Alternate #
Email
An electronic copy of or a web link to the staff report, meeting agendas and the notice of final decision will be emailed
to the applicant at the above listed email address.
Would you like a copy of these to also be sent to the property owner's email address:
Yes No
Paper copies are available upon request.
1. Property address (if vacant, indicate lot or tax
number, access street and nearest
intersection):
2. Tax parcel number:
3. The property is zoned: Property is presently used as:
4. Describe permit application and the nature of
project (attach additional pages if necessary):
5. Have there been any previous zoning permits for the subject property?
Yes
No
If yes, what is the Planning and Building Department case number?
6. Have you met with a planner prior to submitting your application?
Yes No
Planner's Name: Date of pre-submittal meeting:
YOUR APPLICATION WILL NOT BE COMPLETE UNTIL ALL DOCUMENTS LISTED ON THE APPLICATION CHECKLIST ARE
SUBMITTED. YOU MAY NOT BEGIN ANY ACTIVITY BASED ON THIS APPLICATION UNTIL A DECISION, INCLUDING THE
RESOLUTION OF ANY APPEAL, HAS BEEN MADE. CONDITIONS OR RESTRICTIONS MAY BE PLACED ON YOUR REQUEST
IF IT IS APPROVED. AFTER THE CITY HAS ACTED ON YOUR APPLICATION, YOU WILL RECEIVE FORMAL NOTICE OF THE
OUTCOME. IF AN APPEAL IS FILED, YOU MAY NOT BEGIN ANY WORK UNTIL THE APPEAL IS SETTLED. YOU MAY ALSO
NEED APPROVALS FROM OTHER CITY DEPARTMENTS. PLEASE CHECK THIS BEFORE BEGINNING ANY ACTIVITY.
If you suspect that your site contains a stream or wetland or is adjacent to a lake, you may need a permit from the
state or federal government.
Page 3 of 4
DevSvcs-PMC-2.0-20160316
STATEMENT OF OWNERSHIP/DESIGNATION OF AGENT
The undersigned property owners, under penalty of perjury, each state that we are all of the legal owners of the
property described in Exhibit A, which is attached as page 4 of this application, and designate the following to act as our
agent with respect to this application:
Agent:
AUTHORITY TO ENTER PROPERTY
I/we acknowledge that by signing this application I/we are authorizing employees or agents of the City of Kirkland to
enter onto the property which is the subject of this application during the hours of 7:00 a.m. to 5:00 p.m., Monday
through Friday, for the sole purpose of making any inspection of the limited area of the property which is necessary to
process this application. In the event the City determines that such an inspection is necessary during a different time or
day, the applicant(s) further agrees that City employees or agents may enter the property during such other times and
days as necessary for such inspection upon 24 hours notice to applicant(s), which notice will be deemed received when
given either verbally or in writing.
HOLD HARMLESS AGREEMENT - READ CAREFULLY BEFORE SIGNING
The undersigned in making this application certifies under penalty of perjury, the truth and/or accuracy of all
statements, designs, plans and/or specifications submitted with said application and hereby agrees to defend, pay, and
save harmless the City of Kirkland, its officers, employees, and agents from any and all claims, including costs, expenses
and attorney's fees incurred in investigation and defense of said claims whether real or imaginary which may be
hereafter made by any person including the undersigned, his successors, assigns, employees, and agents, and arising
out of reliance by the City of Kirkland, its officers, employees and agents upon any maps, designs, drawings, plans or
specifications, or any factual statements, including the reasonable inferences to be drawn therefrom contained in said
application or submitted along with said application.
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further
certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts
required to enable the jurisdiction to process and review such application. I have furnished true and correct
information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of
work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
APPLICANT
Signature
Property Owner #1
Signature
AGENT (OTHER THAN APPLICANT)
Name
Address
City State Zip Code
Daytime #
Alternate #
Email
Signature
Property Owner #2 (Additional)
Name
Address
City State Zip Code
Daytime #
Alternate #
Email
Signature
Page 4 of 4
DevSvcs-PMC-2.0-20160316
EXHIBIT A: LEGAL DESCRIPTION
Alternate Formats: Persons with disabilities may request materials in alternative formats. Persons with hearing
impairments may access the Washington State Telecommunications Relay Service at 711.
Title VI: Kirkland's policy is to fully comply with Title VI of the Civil Rights Act by prohibiting discrimination against any
person on the basis of race, color, national origin or sex in the provision of benefits and services resulting from its
programs and activities. Any person who believes his/her Title VI protection has been violated, may file a complaint
with the City.
To request an alternate format, file a complaint or for questions about Kirkland's Title VI Program, contact the Title VI
Coordinator at 425-587-3011 or titlevicoordinator@kirklandwa.gov.
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Zoning Permit Application Planning Department Innovative - Responsive (City of Kirkland)

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Completed 3 August 2020

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