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Home My WebLink AboutReport 1CITY OF RENTON DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT MEMORANDUM Date: April 5, 2012 To: City Clerk's Office From: Stacy M Tucker Subject: Land Use File Closeout Please complete the following information to facilitate project closeout and indexing by the City Clerk's Office. Project Name: - ! Taqueria Medina Temporary Use Permit Tier�i- LUA (file) Number: LUA-12-017, TP Cross -References: AKA's: i Project Manager: Kris Sorensen s Acceptance Date: March 15, 2012 t i Applicant: Celia Medina Owner: Yadav & Gill LLC Contact: Same as applicant PID Number: 7227801201 ERC Decision Date: ERC Appeal Date: Administrative Approval: March 15, 2012 Appeal Period Ends: March 30, 2012 s Public Hearing Date: Date Appealed to HEX: By Whom: HEX Decision: Date: Date Appealed to Council: By Whom: Council Decision: Date: Mylar Recording Number: Project Description: Application requesting a Tier 1 Temporary Use Permit in order to locate a walk-up mobile food cart in the parking lot of a gas station located in the Center Village (CV) zone. Location: 2800 NE Sunset Blvd Comments: t V DEPARTMENT OF COMMUNITY �' Ciq'of AND ECONOMIC DEVELOPMENT. PLANNING DIVISION TIER 1 -TEMPORARY USE PERMIT DATE OF PERMIT ISSUANCE: LAND USE ACTION FILE NO.: i;1.Z�a1x�i►l,L�il� PROJECT MANAGER: OWNER/APPLICANT: March 15, 2012 LUA12-017, TP TAQUERIA MEDINA: MOBILE FOOD VENDOR Temporary Use Permit KRIS SORENSEN, Associate Planner YADAV & GILL LLC 2800 NE SUNSET BLVD RENTON, WA 98056 APPLICANT: CELIA MEDINA - TAQUERIA MEDINA 375 UNION AVE SE #75 RENTON, WA 98059 CONTACT (if other than Owner): CELIA MEDINA - TAQUERIA MEDINA, #(425) 829-8087 PROJECT LOCATION: 2800 NE SUNSET BLVD, RENTON WA 98056 DATE OF EXPIRATION: March 15, 2013 PROJECT DESCRIPTION: The applicant proposes to locate a mobile food cart at a property where a gas station is located. The mobile food cart would be located in the parking lot. The vending unit is a truck and would be set-up to offer walk-up food service. Food service will be generally provided daily between the hours of 9 a.m. and 9 p.m., seven days per week. Parking for clients will be provided at the same location and vehicular ingress and egrees to the site is provided from Sunset Boulevard NE, NE 10rh Street, and the access lanes of adjacent retail stores. The following Tier 1 Temporary Use Permit is hereby approved and subject to the following conditions: CONDITIONS OF APPROVAL: 1) A City of Renton Business License must be obtained prior to operation. City of Renton Deportment of .._—munity & Economic Development A_....nistrative Temporary Use Permit TAQUERIA MEDINA: MOBILE FOOD VENDOR Temporary Use Permit LUA12-017, TP DATE OF PERMIT: March 15, 2012 Page 2 of 2 2) All requirements, standards, and permits required of the Seattle —King County Public Health Deportment must be met and approved prior to operation. 3) The mobile food vending unit, or Taqueria Medina, cannot stay at the location permanently and must move daily from the property between 12:00 am (midnight) and 5:00 am, except for a special event where the unit is allowed at the some location for up to 72 hours. 4) The site occupied by the temporary use shall be left free of debris, litter, or other evidence of the temporary use upon completion of removal of the use or when the operation of the use ceases to exist. 5) The site occupied by the temporary use shall be restored to the original condition when the use ceases to exist including restoration of site elements such as, but not limited to, landscaping and parking stall striping. DATE OF DECISION ON LAND USE ACTION: SIGNATURE: C.E. "Chip" Vincent, Planning Director Planning Division 1r ) 12 ai, Date APPEALS: Appeals of permit issuance must be filed with the City of Renton Hearing Examiner by 5:00 p.m. on March 30, 2012. Appeals must be filed in writing, together with the required fee to the City of Renton Hearing Examiner, City of Renton, 1055 South Grady Way, Renton, WA 98057. City of Renton Municipal Code Section 4-8-110 governs appeals to the Hearing Examiner. Additional information regarding the appeal process may be obtained from the Menton City Clerk's Office, (425) 430-6510. D5 - 04 T23N R -5E W 112 R-8 f._ z R-1 R-8 R-34 F 1 s V CU CV CV R-1 1 R -Io r NE ,N BI i cv F R IO R-14 CV RA4 cv cv cv 4 RM -F R8. CV - - y _ NE,im � R-14 w CV Y CN RM -F R-8 NEpi RM -F CV 4h' CV R_8 __ .... CV RM -F cv R-8 NE 1ph $i---RM-F RM -F - RM -F "a _ a NE ,ONB w NE91h Pl R-8 -- R-8 tri -Cv R-8 - i R-8 R-8 cv NE mN R-8 .. R-8 � R-8 R-8.. ... 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R-8 CAN RM -F $ RM -F CA{ CA R-8 i ZONING MAP BOOK F5 - 16 T23N R5E W 1/2 PW TECHNICAL SERVICES E5 PRINTED ON 11/13/09 best iMo:malm arailabk at of the eNe tFonn. ms maoer«ne�e ro,a„aswara�m�a.�y Eltlrz 0 206 400 F 09 T23N R5E W 112 ® Feel r-' r t,Y i 1:4,800 5309 ZONING MAP BOOK 4 92 -- 93: 455-' ��, ----- 4,56 459 —I 461 _ - 8 � 26724N R4E 25 T244R4T 30 T24N R5E 9 T24N R5 28 T24N ASE, 27T24N R5E -- 7. 26 T24N R5E 81L�,;: 94W r., 455VI1 t#5 II I, � � 458 rr.� 46 464 _ , C2'1C3,�- _� CC7 35724NA4E 36 T24N R4E 24N R5 35 T24N R5E3078 r di 3491 �I ` �- gQ - 01 s� - 4 ` 6' T23N R5E s NlaSF T23 4 T28N RSEi ,: t = U 1 t: 3 TiN R5EI 2 T 23N R5E 14 f L !J 31 T �e 35Jj BDA is �8D6FE - . } , 1 i 1 T R4E - :._l�17 12 T23N R4E i� �,T^-� T2 1 R5E 3 R5E r - i. 9- N1 RSE I -.-1$lu 10 TP3N Rpt -r 44 N R5E y 32a', t _ . _ 26 - -,, 32 I 37011 4 _ id T23hTFlAE=:?�l&E aI�i 18 T23N R5E IST ; 3 5E 16 T23N 195E 1.T23N R5E' 14 T2N : y X335 t $3fi 33. I �' 371 815 =81$ LH r T23N R - d4 i gq'y�3 R4E it7 `' 20cT23f FR615-L, - 19 T23N R5E 'I -l� I 21 T23NA5E - 22 T23 R5E ;' 23 T23N t 2 600 sol - 602 820 -- 821 i � :�_ A � T2$N R4E"I JI D1 25 T231(1 R4E - N T23RSE� .= 29:T23N-R5E 28 T23N R5E — T23N R5E 26 T23N R5E 25 CD3 6D4 f 6D 825 _ 826 aV 8 �rLI 1617 $ E P = 36 T23N FII ' 31 T23 R5E 1 ' 2 32� 14 FTSE , i 33 F23N R Y'" T23N R5E 35 T23N R5E - 36 6D�, '_ sD8D - 1- s 610 £32j l 833 =_ � J J �> I - 1`2 2N R4E � j r - 1 Tnp R4E 6 T22N RSE�- 5 T2 "R5E 4 ro 7 ` T22N dd5E��` 3 T22N RISE 2 T22N R5E S T2 RESIDENTIAL Fc (RC) Resource Conservation e_1 (R-1) Residential 1 du/ac a -a (R-4) Residential du/ac Fr -s] (R-8) Residential 8 du/ac inH (RMH) Residential Manufactured Homes R-ic (R-10) Residential 10 du/ac FR- _i4] (R-14) Residential 14 du/ac Rn -F (RM -Fl Residential Multi -Family RM- (RM -T) Residential Multi -Family Traditional RM -u (RM -U) Residential Multi -Family Urban Center 46e test �rierm�lion ew'i be sof 4he ee a show, - i mep is '0� display pl,-�nses o�y MIXED USE CENTERS c (CV) Center Village (UC -N1) Urban Center -North 1 ve (UC -N2) Urban Center - North 2 LTJ (CD) Center Downtown COMMERCIAL roR (CDR) Commercial/Office/Residential cR I (CA) Commercial Arterial 0 (CO) Commercial Office cN (CN) Commercial Neighborhood INDUSTRIAL WH I (IL) Industrial - Light m (IM) Industrial - Medium (11 Industrial -Heavy ----- Renton City UlnitS ---- Adjacent City Limits KROLL PAGE PAGE# INDEX SEC TOWN"GE Ow u� N F O 9 Ln u, Li 04 ., U, ua 2 co ru Zn Z vi W w eD LU w tn H rel cn e� aw y 7c G W tl! di 1 1I IN N - . Ya F Ca t—j-+ H P -d d' G, 04 ., U, ua 2 co ru Zn Z vi W w eD LU tn H rel 04 ., U, ua 2 co ru Zn Z vi DEPARTMENT OF COMMUNITY City of r AND ECONOMIC DEVELOPMENT PLANNING DIVISION TIER 1- TEMPORARY USE PERMIT DATE OF PERMIT ISSUANCE: LAND USE ACTION FILE NO.: PROJECT NAME: PROJECT MANAGER: OWNER/APPLICANT: APPLICANT: CONTACT (if other than Owner): PROJECT LOCATION: DATE OF EXPIRATION: March 15, 2012 LUA12-017, TP TAQUERIA MEDINA: MOBILE FOOD VENDOR Temporary Use Permit KRIS SORENSEN, Associate Planner YADAV & GILL LLC 2800 NE SUNSET BLVD RENTON, WA 98056 CELIA MEDINA-TAQUERIA MEDINA 375 UNION AVE SE #75 RENTON, WA 98059 CELIA MEDINA -TAQUERIA MEDINA, #(425) 829-8087 2800 NE SUNSET BLVD, RENTON WA 98056 March 15, 2013 PROJECT DESCRIPTION: The applicant proposes to locate a mobile cart at a property where a gas station is located. The mobile cart would be located in the parking lot. The vending unit is a truck and would be set-up too er walk-up food service. Food service will be generally provided daily between the hours of 44%. and . .�n' seven days per week. Parking for clients will be provided at the same location and vehicular ingress and egrees to the site is provided from Sunset Boulevard NE, NE 1(yh Street, and the access lanes of adjacent retail stores. The following Tier 1 Temporary Use Permit is hereby approved and subject to the following conditions: CONDITIONS OF APPROVAL: 1) A City of Renton Business must be obtained prior to operation. City of Renton LAND USE PERMIT MASTER APPLICATION, PROPERTY OWNER(S) NAME: t aC1,� t �1 C, O CITY: ZIP: TELEPHONE NUMBER: APPLICANT (if other than owner) NAME;' C -c\ COMPANY (if applicable): ADDRESS: u f� CITY: Ce iA o ZIP: W + , ' p Ll�y, 1 i TELEPHONE NUMBER ^� C• CONTACT PERSON NAME: COMPANY (if91 ADDRESS ,b CITY: ., I'• ','"At ►# ZIP: TELEPHONE NUMBER ANS E MAIL ADDRESS: veb/pwldevserviformslplanninE/masterapp,doc 1 PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: mn AQ 0--e I (� PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: v-700 d KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): EXISTING LAND USE(S): PROPOSED LAND USE(S): ''i EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable): EXISTING ZONING: PROPOSED ZONING (if applicable): SITE AREA (in square feet): SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable): NUMBER OF PROPOSED LOTS (if applicable): NUMBER OF NEW DWELLING UNITS (if applicable): 07/28/05 r PRO.,t-CT INFORM NUMBER OF EXISTING DWELLING UNITS (if applicable): SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): 6 - R SQUARE FOOTAGE OF PROPOSED NON-RESIDEN lAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): NET FLOOR AREA OF NON-RESIDENTIAL BUILDINGS (if applicable): NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): ATION [continueu PROJECT VALUE: IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): ❑ AQUIFER PROTECTION AREA ONE xAQUIFER PROTECTION AREA TWO 0 FLOOD HAZARD AREA sq. ft. ❑ GEOLOGIC HAZARD sq. ft. ❑ HABITAT CONSERVATION sq. ft. ❑ SHORELINE STREAMS AND LAKES sq. ft. ❑ WETLANDS sq. ft. LEGAL DESCRIPTION OF PROPERTY (Attach legal description on separate sheet with the following information included) SITUATE IN THE QUARTER OF SECTION TOWNSHIP , RANGE_, IN THE CITY OF RENTON, KING COUNTY, WASHINGTON. TYPE OF APPLICATION & FEES List all land use applications being applied for: 1. -�6 t r & m4' 3. F 2. _ j _ n�� 4. Staff will calculate applicable fees and postage: $ AFFIDAVIT OF OWNERSHIP 1, (Print Name/s) Cc 15 ria- (nec( i no- G-ag- declare that I am (please check one) 'K the current owner of the property involved in this a lication or the authorized representative to act for a corporation (please attach proof of authorization) and that the foregoing statements a ans herein contained and the information herewith are in all respects true and correct to the best of my knowledge and belief. I certify that I know or have satisfactory evidence that Ca( r,na_ 171�c1 ic4 �lcic_f�' signed this instrument and acknowledged it to be his/her/their free and voluntary act for the r uses and purposes mentioned in the instrument. (Signature of Owner/Representative) (Signature of Owner/Representative) O: web/pw/devsery/forms/planninglrrtasterapp. doc Notary Public in and for the State of Washington $ ' • • N f ct Nota (Print) -14 A "�e VV - My appointment expires: -A- QQ 13 2 07/28105 Footd and facilities Program 401 Fifth Avenue, Suite 1100 Seattle, WA 98104-1818 206-296-4637 Fax 206-296-0188 3 i Y Relay- 711 www.kingcounty.gov/health Use of Commissary Agreement Public _Health Seattle & King County It is required that the operation of a MDbile Food Service unit (carVvehicleltrailer) or Limited Food Service (movable building) be based from an approved commissary kitchen or servicing area. (Be advised that commissary kitchen use outside of King County will not be allowed.) The commissary is an essential part of a mobile unit's operation and must have facilities for supply storage, equipment cleaning, food preparation and other servicing activities. Minimum plumbing requirements for a commissary include a 3 -compartment sink, a mop sink for dumping waste water, and a hand wash sink. An indirectly drained food preparation sink will be required if produce washing occurs as part of the preparation activity. Plan/Permit approval is contingent upon thorough documentation of the servicing activities to be performed at the commissary. Provide scale drawings of the commissary kitchen ... showing the food service equipment and storage to be used_ (All of these items must be addressed ... as incomplete plan submittals may delay approval.) Indicate which of the following services will be allowed for use at the commissary: 9 -3 -Compartment Sink* and Wash Sink* :Food Prep Sink J�-Commercial Refrigeration Space 9 -Dry Storage Space (Linear square feet) geezer Space P --Restroom Access" FYlce Machine 94ey Accessibility to Commissary (if necessary)* pI`Qooking Equipment P'llp- reparation Ta ble/Equipment PlA op Sink* GYCart Storage Space . 9 Off Street Parking for trucksitrailers Other. 'Mfnimum Required Access Commrss i lnforrrrabon: Name of Business: _C a..S, til, 0 cj�-C- ul O �.� Ci 6-h - ie zip: Address: C Uiell0' tr=, -_ GontactPerson: ( �� Title: c7�� Phone: Business Hours of Operation: r - Email: Oo other mobile food c2alvehicle vendors use this kitchen as a commissary? d Yes ' No' 1f so, haw ma ny Mobile Unft/Vendor information: Name of B siness: 1 4-�1 � (MA��` - Owner/Operator: , a' i` f' t '`��1 _Phone: Address:. 7 U '%Y \tom 7 City: -i p: EJ A Days/ Time at Commissary: r g,- A M i' — Email: k V (G'ommissary OwnedAgent – Printed fume & Title) (Mobilellle1P 1611rtEecl Name & Title) (Commissary Owner Agent – Signature & Date) (MobileNender – Signature & Date) This agreement between the owner of the commissary and the ownerlvendor of the mobile food unit operation signifies that both parties agree to the allowed use of the commissary asspt cified. Note that this agreement is not transferable. Should there be a change in ownership of either the commissary or mobile food unit owners, or should there be any modification or cancefation of this agreement between parties, then the Public Health– Seattle & King County Mobile f=ood Service Operators Permit may be suspended. office Use Only CommissarySuitability1NF1 Concurrertce: (Printed Mame) (Signal ) f tel Commissary Agreement 2010 7 Food Establishment Inspection Report >- Form B �1 Public Health = Sea[tte &King Countp JBess Name: Operator: rage o� Address City ZIP Seats / l its Phone: t til� ' q "� �T � .�'� `I General Healtl3 Record ID P!E Date Time.1n Office Time Activity Time Travel Time / t Item I Location 5 < � m m m m [` 1� 127❑Pre-Operat, 106❑HACCP ° Service Temp (°F) ]tem I Location Temp (T) 128 ❑ Scheduled L� r �� Results I 126❑Fid R Rv4v 1301FIComplaint 133❑ liiness 1 inj. 01 ❑ Satisfact Item Number Violations cited in this area must be corrected with the time frame specified. Points 02 ❑ Unsafls#act, 03�_om le e 1340Permit Inv. 136 ❑ Field Educ. r _ ❑ c _� k0 Action Li � V vt . a rEo eraEo�a Comments—, n f f -..— r,� t tZT, ! i`r;s esf hfishmeot'srteatt�r F�emriAp•tfi:-afiar: is Based on an inspection this day, the above items are violations, whicrh must be corrected in the time specified by the health officer. A food estr appro+.ad, Tnis appmvuf-da2s-Fiat allawYou to oie. (T without warning, notice or hearing If the requirements of the food code and/or directives of the health officer are not met m if violations are n wiizoc,.' obfaiRisg the necessary permits and report. The permit will he suspended if an imminent hazard exlsts or there are 90 or more red critical points or if there are 120 or more total po. opportunity for an appeal an the validity of a susponsion or the findings of an inspection report if a written request is filed with the health officers irspecri rrs, Y;s, 11 law may �e Enf P d it cthyr or inspection. The filing of an appeal does not stay the effectiveness of a suspension. The completed inspection farm is a public document that rX'!! serve zs a rea7r5 permit nrfif rcu who requests it under the provision of the Public Disclosure Act (4217.260 RCW), pentane:+ h+ a{i'r pemti is re-eis•ad. 8e adds -_d ±hat rnriv fF rc cranes r'9QLire Prior hea)th anvi ove{. Person in Charge• / _ } `i {Signature} (Printed Name) Regulatory Authzq, / [` 1� 127❑Pre-Operat, 106❑HACCP 1 t \ Results o 01 ❑ Satisfact Item Number Violations cited in this area must be corrected with the time frame specified. Points 02 ❑ Unsafls#act, 03�_om le e 'Q`4 ❑ Incomplete ❑ c _� k0 Action �/� - ---+ �_ q I E� st , f `�✓( s�j t i t j`t Lys f EJiilL L �I c� { 04 ❑Sus end p Q7 p cved - to E Disapprv'd _ L;l t_�[ N`'- 26 ❑FoVup Rq'd Trans Fat i _ vrA, 1 7130 ❑ May 2006 =: F`; L r "!— ti`s f' i F l .�� 1 f, t l 6w_.-. � f, Leo L f 7140 ❑Fed 2009 7150 ❑ Documnts fir • - Nutrition '�� `;� ' t 1 ``•'-� f w '=E� C� t i = -- — Labeling 7200❑Applies 7220❑Menu 7230 ❑ Menu fad 7240 ❑,Pi. of Order! h �� jJti v r � r �- , � � � �`"� �✓ t � ��,.y �t�..- / f' ��. ��-\'� ; L. ��, ��= L ''.-s �l � 7-2' �tafemeniZ28 Leak'A Li � V vt . a rEo eraEo�a Comments—, n f f -..— r,� t tZT, ! i`r;s esf hfishmeot'srteatt�r F�emriAp•tfi:-afiar: is Based on an inspection this day, the above items are violations, whicrh must be corrected in the time specified by the health officer. A food estr appro+.ad, Tnis appmvuf-da2s-Fiat allawYou to oie. (T without warning, notice or hearing If the requirements of the food code and/or directives of the health officer are not met m if violations are n wiizoc,.' obfaiRisg the necessary permits and report. The permit will he suspended if an imminent hazard exlsts or there are 90 or more red critical points or if there are 120 or more total po. opportunity for an appeal an the validity of a susponsion or the findings of an inspection report if a written request is filed with the health officers irspecri rrs, Y;s, 11 law may �e Enf P d it cthyr or inspection. The filing of an appeal does not stay the effectiveness of a suspension. The completed inspection farm is a public document that rX'!! serve zs a rea7r5 permit nrfif rcu who requests it under the provision of the Public Disclosure Act (4217.260 RCW), pentane:+ h+ a{i'r pemti is re-eis•ad. 8e adds -_d ±hat rnriv fF rc cranes r'9QLire Prior hea)th anvi ove{. Person in Charge• / _ } `i {Signature} (Printed Name) Regulatory Authzq, Public Health 1.10 Seattle & King County 2011 Plan Review Application for a Mobile Food Service Unit O eration Information (Please Print) Operation Name (Doing Business As): L Mobile Unit Operating Location: kSingle Site Single 3fte Address: 37S Um on ctvc Scope (Briefly describe operation/menu style Former Name: d k L4— o Required Information: WA License Plate # -1 ❑ Multiple Sites/Route (Include all local city: Plan Review Submittal Fee Make checks payable to New Operation ($764 + $191/hr after 4 hours) (5602) ❑ Resubmitted Pian ($191/hr) (S605) ❑ Cost of Service Ownership Information Are you the new owner? Yes Er, No a Name(s):First Ic., M.I. Business Name (Corp, LLC, etc): Mailing Address: c�ti�,at1 o v Phone Fax (Optional): Email Applicant Information If different from owner Contact l Person (Applicant or Agent) Name(s): L_ First -Q_k C1 M.I. Business Name (corp, LLC, etc): C>ti u �_� ( C _ Mailing Address. n c0J C SG Phone No.'s Fax (Optional): Email SEAT LF --KING CO. P LIC HEALTH EIJVIVAMENIAL HEALTH SERVICES 06-10-2011 FRI #0 11 FOOD PIAN AEU 164,00 CASH T641 00 v ~. JFNNI1 LR Unit Type: ❑ Cart�ehicle 8303 15 34Thi VIN # WA t, tk r �7uuncR L. - �r.rJ P_5333Si5y*ran Check N, O. S. # "SKCDPH") []Mobile changes ($382 + $191/hr after 2 hours) (5611) S191/hr) (HO09) G I }_City: State: ,.';-Plan Check State;Zip:_CI�� Commissary Information Se 'arate Commissary Permit is required for all mobiles. •:•Pro ert Information Business Name: LocationfAddres : �J City: �+ State: 1 .^Zip: D l Commissary ne 1 ontact Person: t 1 ^ r rlc Phone (yd -,5) -713'' 0 j No_: Fax (Optional): Email (Optional): Sewage: ❑ Sewer E7 Septic System Restroom Information (Must provide restroom availability letter for each stop that lasts longer than 1 hour) -.*-SR Info Add Comment Sec. Business Name: r 1 Location/Address: Business Owner/Contact Person: M ,` c' Fax (Optional):Email ❖Office Use Ont Date Submitted:sk Classification: Facility Account FAA: Account Receivable AR#: Variance SR#: hermit Record PR#: Approval Date: Review TiMo- Reviewer: _ Notes: : 54 4 Ca 1 _ State:. Phone No.: Sewage: ❑ 5 v v • C.O /q Zip: ❑ Septic System Service Request SR#: --- _ DPD/DDES #: Mobile Sticker # PLAN REVIEW APPLICATION SU13FAITT -:_ Downtown Seattle 401 5t' Avenue, Suite 11001 ': 71:1 �`, 1 (1 Seattle, WA 98104 2011 3 .a (206) 296-4632 , S/Ehsharel7'echdara/F'ood,'FoodFarmsrMobile Plan Rrvinr*,ZCarron Revised-- 113111 GLIA MEDINA TAQUERIA MEDINA 375 UNION AVE SE # 75 RENTON WA 98059-5170 DETACH BEFORE POSTING 001645 TAT, MASTER LICENSE SERVICE PO Box. 9034:.• Olympia, WA 98507=9034 • (360) 664-1.400 ��p Y�a4ti RE ISTRAT _ONS AND _LICENSES STATE OF WASHINGTON Unified Business ID # 603 091 883 Sole Proprietorship Business ID #: 1 Location: 1 CELIA MEDINA TAQUERIA MEDINA 375 UNION AVE SE # 75 RENTON WA 98059 5170 TAX REGISTRATION UNEMPLOYMENT INSURANCE The licensee named above has been issued the business registrations or licenses listed. By accepting this document the licensee certifies the information provided on the application fDrthese licenses wes complete, true, and accurate to the best of his or her knowledge, and that business will be conducted in compliance with all applicable Washington state, county, and city regulations. 0��,/ cl: N w V Q ra Od _r 0 N H P4 t0 W w �a a� G ra Od _r N H P4 t0 W w G h p�1q� U y cn a R L1 04 N N N P4 ra Od w z W z n U] _r N H P4 t0 w G w z W z n U] c 0 vi a� s F H H 0 W to w Y7 IN,. Fk i r � sn s. 1� us C! N v r cti w. w N N w w M w 0 W to w Y7 IN,. x . ZA �L -l� BLy Alkw 3 _ LLI `7- ►"' i �-F �` �4 u = +r fit-, 9 `r er"a Ageing -Authentic We.#can Woad Tacos Asada (Diced Mexican steak style) Taco de trompo (pork, onions, pineapple) Adobada (BBQ park) Pollo (chicken) Chorizo (Mexican pork sausage) Veggie (vegetables of the day) small $1.25 Large $2,50 RWAIM $7.00 (All burritos are made with flour tortilla and your Choice of meat, lettuce, rice, beans, cheese and sour cream) T (Mexican Sandwich) $7.00 with drink (Choice of your meat, lettuce, tomato, onions, Mayonnaise, avocado) Quesadillas $6.00 (Choice of meat, flour tortilla Cheese burritos and rice$3.00 mallu $3.00 Taco and rice $3.00 (Choice of meat, corn tortilla, cheese) Rice and beans$2.50 Carne Asada $12.00 (Thin Sliced beef, rice, beans, flour tortilla Or corn tortilla) th m I $7.00 with drink ('Whole wheat pita bread served with beans lettuce, Choice of meat or Vegetables and cheese, salsa, Sour cream) D in Mexican Coca-Cola $2.00 Water $1.00 Coca-Cola Can $1.00 Jarritos $1.50 Catering Available Contact us Number: (425)-623_9214 Oa c4v f:�O�n eo' s LL 0 �CJ v CA �- f - Club A Ate.t UN'b o �\JA S �j 'Mo i i c \j k o cllDT Printed: 03-12-2012 Payment Made: CITY OF RENTON 1055 S. Grady Way Renton, WA 98055 Land Use Actions RECEIPT Permit#: LUA12-017 03/1212012 04:26 PM Total Payment: 77.25 Current Payment Made to the Following Items: Receipt Number: Payee: Celia Medina Trans Account Code Description Amount ------------------------------------------------------ ---------------- 3080 503.000000.004.322 Technology Fee 2.25 5021 000.000000.007.345 Temp Use, Hobbyk, Fence 75.00 Payments made for this receipt Trans Method Description Amount ---------- -------- --------------------------- --------------- Payment Cash 77.25 Account Balances Trans Account Code Description Balance Due ------ 3021 ------------------- 303.000000.020.345 ------------------------------ Park Mitigation Fee ---------_--__-- .00 3080 503.000000.004.322 Technology Fee .00 3954 650.000000.000.237 Special Deposits .00 5006 000.000000.007.345 Annexation Fees .00 5007 000.000000.011.345 Appeals/Waivers .00 5008 000.000000.007.345 Binding Site/Short Plat .00 5009 000.000000.007.345 Conditional Use Fees .00 5010 000.000000.007.345 Environmental Review .00 5011 000.000000.007.345 Prelim/Tentative Plat .00 5012 000.000000.007.345 Final Plat .00 5013 000.000000.007.345 PUD .00 5014 000.000000.007.345 Grading & Filling Fees .00 5035 000.000000.007.345 Lot Line Adjustment .00 5016 000.000000.007.345 Mobile Home Parks .00 5017 000.000000.007.345 Rezone .00 5018 000.000000.007.345 Routine Vegetation Mgmt .00 5019 000.000000.007.345 Shoreline Subst Dev .00 5020 000.000000.007.345 Site Plan Approval .00 5021 000.000000.007.345 Temp Use, Hobbyk, Fence .00 5022 000.000000.007.345 Variance Fees .00 5024 000.000000.007.345 Conditional Approval Fee .00 5036 000.000000.007.345 Comprehensive Plan Amend .00 5909 000.000000.002.341 Booklets/EIS/Copies .00 5941 000.000000.007.341 Maps (Taxable) 00 5998 000.000000.000.231 Tax 00 R1201077