HomeMy WebLinkAboutExhibit04_PublichealthDoc_LUA24-000200_111AirportWayCEIVER
APR 27 2023
Plan Review Application for(REQUIRED)
Permanent Food Service Establishments
Environmental Health |Food Protection Program
D Downtown Chinook:401 5 Avenue,Ste 1100,Seatte,WA 98104 |(206)263-9566
D Bellevue Eastgate:14350 SE EastgateWay.Bellevue.WA 98007j(206)477-8050
Altemative fomats available upon request.
Public Health
Seattle &King CountyBY:
(tf you are proposinga mobile food business or Limied Food Service business,use the Mobile PlanReview Application)
Make checks payable to:"SKCDPH".NOTE:Plan review fees are non-refundable and plan review time beyond the base time will be charged
at therate of$229.80perhour.You willpayaseparateannualpermitfeebeforegpening.
TYPE OF PLAN REVIEW (Check Applicable Box)
Constructing a new kitchen OR re-pemitting an existing kitchen that has
not beenusedforone(1)yearormore.
Changing or remodeling an existing food service establishment.
In alargefacilitywithmultiplefoodserviceoperations(hotel,grocery,etc.)
each operation requíres a separate plan review (and eventualy a separate
permit)
Oncetheplanshavebeenapproved,an hourlyratewillbechargedfor
subsequentchangestotheequipmentfloorplans.
S919.20-New construction (4 hour base time)
XS689.40–Remodel (3 hour base time)
S689.40-Multiple pemitted establishment(3
hour base time)
$229.80-Resubmitted planreview (Hourly rate)
GENERAL INFORMATION
Project Scope (describe project;if applicable the length of time the business has been closed and fomer name):
Propose to add out door dining of max.14 seats on existing approved restaurant (2020)
Is thisprojectin"Unincorporated King County?:Parcel Number:|For CityofSeattle,DPDProject#
XYes No |722930-0035
Water supply:(Check one)Sewage Disposal:(Check one)
XSewer
Name of Sewer District:
Hot watertanksize:
XPublic onsitesepticsystem80Privatewatersupply
Name ofWater Distict:
FACILITYIPROPERTY INFORMATION (Service Request)
NameofBusiness:E Muchacho Alegre
Siteaddress:111 Airport Way Any specialized menu processes (sous vide,vacuum packaging,etc.)?2:
ZipCode:
98057
SeatCount(insideand ifanyoutside):
|131City
Renton
BUSINESS OWNER INFORMATION (Requestor)
Owner/RequestorName:Jesus Orozco
Maiingaddress:411 Airport way
State:Wa
PhoneNumber 2065654635
Zip:98057CityRenton
Email:mariscosema@gmail.com
APPLICANTICONTACT,INFORMATION -If not the business owner (PlanCheck)
ContactPerson(ApplicantorAgent)Names:Andv Teh
Maiingaddress:1009 9th Ave S
City:Edmonds Sale:Wa
PhoneNumber:4257711192
Zipcode:g8020
Em:andyteh@andyteh.com
OFFICE USE ONLY INga4ub34
Date submitted:
Daleapproved:
Notes:HEI:Ernie Navarro
Cy21|202?
7/10/2023
SR#:SP4NS00RiskClassification:6723
Reviewer.D.Bondoc PR#0089365
Notice:Bysigningthis form,youattest totheaccuracyof theinformationprovidedin thisapplication.
ANDY TEH Oate:0ž-o7-2023Signature:Print