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HomeMy WebLinkAboutCHILOLOS SUBMITTAL/PROPERTYOWNER(S)NAME:ADDRESS:,4c’:i,SjZIP...APPLICANT(ifotherthanowner)NAME:QitcotaiCOMPANY(ifapplicable):0t0cADDRESS:ensIMIhCITY::-)JjZIP:TELEPHONENUMBER:?0)zflc3CONTACTPERSONNAME:COMPANY(ifapplicable):tke4z5ADDRESS:Cot?r&,‘jCITY:ZIP:ij..j‘4TELEPHONENUMBERANDEMAILADDRESS:%2c.-zc---Sk—-us.H:\GED\Data\Forms-Templates\SeIf-elpHadouts\Planning\MasterApplicationdoc@LL1jTELEPHONENUMBER:2o1S(t--z5cPROJECTINFORMATIONPROJECTORDEVELOPMENNAME:.ruPROJECT/ADDRESS(S)/LOCATIONANDZIPCODE:AKINGCOUNTYASSESSORSACCOUNTNUMBER(S):OSc(yEXISTINGLANDUSE(S):?LikVjtPROPOSEDLANDUSE(S):fs4EXISTINGCOMPREHENSIVEPLANMAPDESIGNATION:PROPOSEDCOMPREHENSIVEPLANMAPDESIGNATION(ifapplicable)EXISTINGZONING:PROPOSEDZONING(ifapplicable):‘.SITEAREA(insquarefeet):SQUAREFOOTAGEOFPUBLICROADWAYSTOBEDEDICATED:SQUAREFOOTAGEOFPRIVATEACCESSEASEMENTS:PROPOSEDRESIDENTIALDENSITYINUNITSPERNETACRE(ifapplicable)NUMBEROFPROPOSEDLOTS(ifapplicable)NUMBEROFNEWDLLINGUNITS(ifapplicable):‘-1-CityofRentonLANDUSEPERMITMASTERAPPLICATION PROJECTINFORMATION(continued):NUMBEROFEXISTINGDWELLINGUNITS(ifapplicable):PROJECTVALUE:SQUAREFOOTAGEOFPROPOSEDRESIDENTIALISTHESITELOCATEDINANYTYPEOFBUILDINGS(ifapplicable):’ENVIRONMENTALLYCRITICALAREA,PLEASEINCLUDE______________________________________________SQUAREFOOTAGE(ifapplicable):SQUAREFOOTAGEOFEXISTINGRESIDENTIALBUILDINGSTOREMAIN(ifapplicable):LiAQUIFIERPROTECTIONAREAONESQUAREFOOTAGEOFPROPOSEDNON-RESIDENTIALLiAQUIFIERPROTECTIONAREATWOBUILDINGS(ifapplicable):__________________________________________LiFLOODHAZARDAREA______sq.ft.SQUAREFOOTAGEOFEXISTINGNON-RESIDENTIALBUILDINGSTOREMAIN(ifapplicable):LiGEOLOGICHAZARD______sq.ft.NETFLOORAREAONNON-RESIDENTIALBUILDINGS(ifLiHABITATCONSERVATION______sq.ft.applicable):____________________________________________LiSHORELINESTREAMS&LAKES______sq.ft.NUMBEROFEMPLOYEESTOBEEMPLOYEDBYTHENEW-.PROJECT(ifapplicable):LiWETLANDS_______sq.ft.LEGALDESCRIPTIONOFPROPERTY(Attachlegaldescriptiononseparatesheetwiththefollowinginformationincluded)SITUATEINTHE________QUARTEROFSECTION___TOWNSHIP‘RANGE___INTHECITYOFRENTON,KINGCOUNTY,WASHINGTON——AFFIDAVITOFOWNERSHII’.-1I,(PrintName/s)JdeclareunderpenaltyofperjuryunderthelawsoftheStateofWashingtonthatIam(pleasecheckone)thecurrentownerofthepropertyinvolvedinthisapplicationortheauthorizedrepresentativetoactforacorporation(pleaseattachproofofauthorization)andthattheforegoingstatementsandanswershereincontainedneinfortionherewithareinallrespectstrueandcorrecttothebestofmyknowledgeandbelief.SignatureOwner/RepresentativeDateSignatureofOwner/RepresentativeDateSTATEOFWASHINGTON)SSCOUNTYOFKING)IcertifythatIknoworhavesatisfactoryevidenceii4ViL2A1Y57frç’signedthisinstrumentandacknowledgeittobehishertheirfreeandvoluntaryactfortheusesandpurposementionedintheinstrument.DaeNotaryPublicinandfortheStateofWashingtonaton==Notary(Print):ILt/MyAppointmentExpiresJul9.2018Myappointmentexpires:‘JGi/q.i€.9H:\CED\Oata\Forms-Templates\SeIf-HelpHadouts\Planning\MasterApplkation.doc- L9L96€LWSHirI-•“‘f.4’MflA‘•-;-••‘•.••-,:r‘-,-:..•--“-•‘——;‘:rec$’‘C-‘—‘-_•3‘--•S%’bY.C4’‘.:-.t•?i-:.;l•-•LM’••••.;4•t“‘-4aaa. * EnvironmentalHealthServicesDivisionpiiblrH21th401FifthAvenue,Suite11001.,Seattle,WA98104-1818Seattle&KingCounty206-263-9566Fax206-2g6-018gTTYRelay:711www.kingcounty.gov/healthApril25,2017TransmittedviaelectronicmailandUSMAILOscarNicolasRamirez8711S.114thStreetApt.1*1Seattle,WA98178206-327-4198RE:PlansandSpecificationsforaNewMobileFoodServiceUnit:ChilolosTacosCommissary:RedHouse,65384thAvenueSouth,Seattle,WA98108(PR0014364)Sitelocation:618ParkAvenueNorth,Renton,WA98057SR1396787P/E6783(Risk3;MobileUnit)MobileSticker:KC589DearMr.NicolasRamirez,Theplansandspecificationsfortheabovenewprojecthavebeenreviewedand,inaccordancewiththeprovisionsofTitleS,theCodeoftheKingCountyBoardofHealthRulesandRegulations05-06(TheFoodCode)areherebyAPPROVEDandsubjecttothefollowingconditions:1.Asinstructedonthephone,thefoodpreparationsinkonthemobilehasbeenremoved.2.Menu:Anypotentiallyhazardousfoodsforyouroperationmustbestoredinthemobile’scoldandhotholdingequipmentatalltimes.Allrawproteinsmustbeprecooked.3.Refrigeration:Allpotentiallyhazardousfoodsthatarekeptcoldmustbeatorbelow41Fatalltimesintherefrigerationprovided.4.Useofthecommissary:Regularuseoftheapprovedcommissaryisexpected.(Extrastorageandequipmentandutensilcleanupactivity,etc.).5.Leftoverfoods:Leftoverfoodscannotbecooled,reheatedandusedthenextday.6.Wastewaterdisposal:Wastewatermustbedisposedatthecommissarymopsink,orotherapprovedlocation.7.Nochanges:NochangesshallbemadewithoutHealthDepartmentapproval.TheHealthDepartmentmustgrantapprovalforanyremodelingofthemobilefoodunit,changeofthecommissary,changeofmenu,orsignificantchangestothemethodsoffoodpreparationorstyleofservice.YourestablishmenthasbeenassignedthefollowingplanreviewservicenumberSR1396787.PleaseusethisSR#inallfuturecontactwithus.AsrequiredinTheFoodCode,uponcompletionoftheconstructionandbeforeopeningforbusiness,thefoodserviceestablishmentoperator/ownershall:1.Obtainapreoperationalinspectionapproval.ContactJohnShinat206-263-8531toscheduleapreoperationalinspectionatthecommissary(REDHOUSE).2.Pleasebepreparedtoshowthefollowingduringthepreoperationalinspectionatthecommissary.ThefollowingwillbeverifiedtoensurethattheinformationsubmittedmeetstherequirementsoftheFoodCode: ChilolosTacos(KC5$9)-SR1396787April25,2017a.Freshwaterhose:Thefreshwaterfoodgradehoseandwhereitisstoredwhenitisnotinuse;showhowthefreshwatertankisfilled.b.Wastewaterhose:Thequickdisconnectortightlyplumbedwastewaterhoseforthewastewaterholdingtank;showhowthewastewateristransportedanddisposed.c.Handwashsink:Handsinksatthecommissaryandonthemobilefoodunitmusthavehotwaterofatleast100F,soapandpapertowels.d.Refrigerationunits:Allrefrigerationunitsatthecommissaryandonthetrailermustbeatleast41Forbelowandhaveadisplaythermometerinside.Note:Pleaseputasmallcuporcontainerofwaterinalloftherefrigerationunits(insidethetruck).e.HotHolding:Allhotholdingequipmentatthecommissaryandonthetrailerthatyouareplanningtousemustbeturnedonandat135Fandabove.f.Commissarystorage:Pleaseshowatthecommissarywhichrefrigerationunits/shelvesisreservedforyourmobilebusiness.g.Allequipmentmustbeavailable:Ensurethatalloftheequipmentisonthevehicleandinthecommissary.YourapplicationforafoodserviceestablishmentpermitfromPublicHealthSeattle&KingCountymaybeapprovedduringthisinspection.However,itistheresponsibilityofthefoodserviceestablishmentoperator/ownertoobtainallnecessarypermitsandapprovalsfromotheragencies.Operatingtheestablishmentwithouttheserequiredpermitsorapprovalsmaysubjecttheoperator/ownertolegalactionbytheappropriateagencies.IfthemobilefoodunitisopenedwithouttheHealthDepartmentpreoperationalinspection,itmaybesubjecttoclosure.Failedpreoperationalinspectionswillrequirea$430.00fee(+$215.00/hrafter2hours)forarepeatinspection.Pleasebeawarethatadditionalhourlyfeeswillbechargedifthetotalplanreviewandpreoperationalinspectiongoesbeyondthebasefour(4)hoursfarthisnewproject.Aninvoicemaybesenttoyouafterthepreoperationalinspection.Yourinspectorwillcontactyoutoarrangeascheduledinspectionatthecommissarytodeliveryourpermitandannualmobilesticker.Ifyouhaveanyquestions,pleasedon’thesitatetocontactme.ThankyouforyourcomplianceinthismatterandIlookforwardtoseeingyousoon.Sincerely,JohnShin,R.SFoodandFacilitiesPlanReviewerJLSCc:MartaLema,HealthandEnvironmentalInvestigator2 WNBOARDS,UTENSILRACKS,ORBLESLARGEENOUGHTOCCOMMODATEALLSOiLEDANDCLEANEDEMSSHALLBEPROWDEDFORCESSARYUTENSILHOLDING...BEFORELEANINGANDAFTERSANrn7]NG.VAREWASHING/DISHWASHINGSINKOMPARTMENTSSHALLBELARGEHTOACCOMMODATESIONOFTHELARGESTtANDUTENSILS.iv—It—-oSLov1ECkI—Jwic-L“rmentandFeatures2)Operablewindowawnings1)Stainlesssteelfold-outserviceshelves(72Wx11“D)1)Plexiglassconcessionwindows(72Wx36”H)withslidingopening(20”Wx20”H)tainlesssteelworksurface(18-314”Dx35’H)tainlesssteelworksurface(27Dx35H)ontinuouswireshelvingaboveeamlessweldeddiamond-platealuminumflooringthroughout7-11,2”ndwhPramTable(TurboJrMST-28j,.j317l(r318.Propanewterheater(TakagiT-KJR2-IN)19.Electricwaterpump(SHURfl04008-171-E65)20.Sprayerwithfaucetassembly21.75”Three-basinsinkwith15”WxI5”Lx12”Dbasinwithdual22.18-1/2”Prepsinkwith15”Wx15”Lx12”Dbasinwithoutdrain23.17”Handsinkwith14Wx1OLx5”Dbasinwithsidesplash24.80gal.freshwatertankbelowcounter25.98aal.arevwatertankbelowfloor OODSERViCEOPERA77ONAREAFLOORS,OORCOVERINGS,WALl4,WALLOVERiNG$,ANDCEILINGSSHALLBEESlGNED,CONSTRUCTEDANDI“OTHEYARE$MOOTHDURABLEANDASILYCLEANABLE•equlpmentthatiscertifiedforsanitationbynAmericanNationalStandardsInstitute(ANSI)iccieditedcertificationprogramwillcomplywith-equipment&utensilmaterial,nddesignrequirements.72”02tt,t2’2WAND-.SHALLSPEAKHOTIGKOUTE—aL___01U)F-.F—01N‘fr;Ci-U)1’-Lt31,71?EquipmentandFeaturesBEADWSEDTHATTHENEWWASHINGTONSTATEFOODCODEREQWRESCOMMERCIALREFRIGERATiONTOHOLDFOODAT4IDEGREESFAHRENHEITORBELOWUt(DOWNFROM45DEGREES)1.(2)Operablewindowawnings2.(2)Stainlesssteelfold-outserviceshelves(72Wx1i’D)3.(2)Plexiglassconcessionwindows(72Wx36”H)withslidingopening(20”Wx20H)4.Stainlesssteelworksurface(18-3/4Dx35’H)5.Stainlesssteelworksurface(27’Dx35”H)6.Continuouswireshelvingabove7.Seamlessweldeddiamond-platealuminumflooringthroughout6.27-112”SanichPrpThbleboAirMST-28)9..2”2W.i1SteunTl.iMetaIHF-2G-LP)10.48Griddle(8tratusSM’4r11.12”CharBmiler(RadlenceT12)-l2l22-OpenATHP-i2-2)’13.72’Equipmentstand(RoyalIndustriesROYES3072)14.Roofairvent(12”Lx12”W)15.9’Ventilationhood-stainlesssteel(CaptiveAire3044BD-2)18.Propanewaterheater(TakagiT-’19.Electricwaterpump(SHURIIo40-171-E65)20.Sprayerwithfaucetassembly21.75”Three-basinsinkwith15’Wx151x12”Dbaslnwithdualdralboard22.18-1/2”Prepslnkwtth15”Wx15”Lx12’Dbasinwithoutdralthoard23.iT’Handsinkwith14”Wx10”Lx5’Dbasinwithsidesplashguards24.80gal.freshwatertankbelowcounter25.98gal,greywatertankbelowfloor’W0,eLI.”c11LOPlI26.FreshwatertankbypassInlet27.Freshwaterinlet28.125Aelectricalpanel(EatonCutter-Hummer)29.50Agenerator/shorepowerinlet30.(4)Stabilizerscissorjacksweldedtocournersofchassis31.(2)100.propanetankholderlockablecageswithopentop32.Diamond-cutaluminumhitchporch PublicHealthSeattle&KingCountyAppendixCUseofCommissary/SharedKitchenAgreementAllFoodEstablishmentsmustoperateoutofanapprovedfacilitylocatedwithinKingCounty.ManyfoodoperationssuchasMobileFoodUnitsandCaterersutilizecommissariesthatarenotundertheirownownership.Thisformshallbecompletedifyouarenottheownerofthecommissaryorifyouwillbesharingkitchenfacilitieswithothervendors.Thecommissarymusthavefacilitiesforsupplystorage,equipmentcleaning,foodpreparationandotherservicingactivities.Minimumplumbingrequirementsforacommissaryincludea3-compartmentsink,amopsinkfordumpingwastewater,andahandwashsink.Anindirectlydrainedfoodpreparationsinkwitiberequiredifproducewashingoccursaspartofthepreparationactivity.Plan/Permitapprovaliscontingentuponthoroughdocumentationoftheservicingactivitiestobeperformedatthecommissary.Providescaledrawingsofthecommissarykitchenshowingthefoodserviceequipmentandstoragetobeused.(AlloftheseitemsmustbeaddressedasIncompleteplansubmittalsmaydelayapproval.)Indicatewhichofthefollowingserviceswillbeallowedforuseatthecommissary:3-CompartmentSink“HandWashSinkfr6odPrepSink“CommeccialRefrigerationSpace[pryStorageSpace(squarefeet)FreezerSpace[RestroomAccessEIceMachine‘KeyAccessibilitytoCommissaryfIfnecessary)CookingEquipmentgPreparationTable/EquipmentEMopSinkOffStreetParkingfortrucks/trailersOther:_________________________CommissaryInformationNameofBiness:tZEb/)OLft.d./50t?oCjht/PermitNumber:PROOI%.3C4Address:4-Ta4vSCity:5ñrTLZip:/o3ContactPerson:At.iy2tiL.DPhone:O4-!‘4--14.Email:tJlYL/SEO/rL.O(‘G”4/L-,BusinessHoursofOperation:IIAr7—3,t?’1,tc4_6ZjDoothervendorsusethiscommissary?YesNoifso,howmany?_____MobileUnit!Caterer!VendorInformationNameofBusiness:V’j,-¶o.cp5PermitNumber:PROwner:cittpto/lçtiJCofPhone:o6)37?4&Email:Aç]ji5l&’cDays1rithetpommissary:Address:R.fkSII44s-b.#ICity:dii,&’gZip:‘79/z9- --c5cdt(CommissaryOwner/Agent—PrintedName&Title)(MobileUnit/CatererNendor—PrintedName&Title)5/al/i--/%q/ICommissaryOwner/Agent—Slgnatd1e&Dte)(MobileUnIt/CatererNendor—Signature&ate)Thisagreementbetweentheownerofthecommissaryandtheoperatorofthemobileunitcatererorvendorsignifiesthatbothpartiesagreetothealloweduseofthecommissaryasspecified.Notethatthisagreementisnottransferable.Shouldtherebeachangeinownershipofeitherthecommissaryormobileunit/caterer/vendor,orshouldtherebeanymodificationorcancelatlonofthisagreementbetweenparties,thenthePublicHealth—Seattle&KingPermanentFoodServiceEstablishmentPermitmaybesuspended.AvalIbIeinalternatIveformatuponrequestpursuanttoADAForOfficeUseOnly:‘3HealthOfficerapprovalforuseofcommissarybythemobilefoodunitowner/vendoridentifiedabove:Hea’thandEnvironmentallnvestigatorlMPRAFCompanceOfficerI/zs//PrintNameSlnature(DateDISTRICTHETHCENTEI{SDOWNTOWNEASTGATE4015’Ave11thfloor14350S.F.EastgateWaySeattle,VA98104BeflevueWA98007206-263-9566206-477-8050P00iq367/3S:iSHAREThATAWoodWoodFosOl7FoodFoni PREOPERATIONALINSPECTIONCHECKLISTCongratulations!Beforeyoumayopenforbusinesstothepublic,thefollowingitemsmustbecompletedbeforecontactingtheHealthDepartmentforapre-operaflonalinspection:oFinalplumbingpermitsignedoffandapprovedbyyourlocalplumbingjurisdiction.Pleasehavetheplumbingpermitonsiteatthetime.ofthepreopeninginspection.ciCompletethe“ApplicationtoOperateaPermanentFoodServiceEstablishment”formandsubmittheappropriatelee(makecheckspayabletoSkCDPHl.PublicHealth—Seattle&KingCountyEnvironmentalHealthDivision—LicensesandPermits4015hAveSte.1100Seattle,WA98104oHotwateratallhandsinks(includingsharedpublicrestrooms)musthaveaminimumtemperatureofatleast100°F.Soapandpapertowelsmustbeavailableatallhandsinks.oIfapplicable,thedishwashermustbeproperlyoperating(chemicalorheatsanitation).oEquipmenttunctioningproperly(refrigeration,etc).Provideadisplaythermometerinallrefrigerationunits.oRestroomandseatingcountmeetscodeandplanrequirements.oBuiltaccordingtoplan.oFloors,walls,ceilingsaresmooth,non-absorbent,andeasilycleanable.Floorwaltjunctionsmusthaveacovedbase.Allwoodsurfaces(doors,trim,shelves,cabinets,etc)mustbesealed.Informationonmenulabeling,transfat,ahdemployeehealthcardinformationwillbediscussed.Açlditionalinformationsuchascooking,cooling,re-heating,coldholdIng,handwashing,andcrosscontaminationwillbeavailableuponrequest. —DEPARTMENTOFCOMMUNITY-ityANDECONOMICDEVELOPMENTLiJi--CityofRentonPlanningDivision1055SouthGradyWay,Renton,WA98057Phone:425-430-7200Fax:425-430-7231‘SI,cscfJ%vtheLocationof:\1tcJGs€8Pc.i(AibeingtheApplicantfortheTemporaryUsePermitatHerebyauthorizetheCityofRentontosummarilyeliminatetheTemporaryUseandallevidenceoftheuseifithasnotbeenremovedasrequiredbythetermsofthepermit.IalsoagreetoreimbursetheCityforanyexpenseincurredinabatingthisTemporaryUse.Signature:PrintName:Date:ttotc//6y///STATEOFWASHINGTONCOUNTYOFKINGDated:___________SSABATEMENTAGREEMENTTEMPORARYUSEIcertifythatIknoworhavesatisfactoryevidencethat1)1(‘ôtLsignedthisinstrumentandacknowledgedittobehis/her/theirfreeandvoluntaryactfortheusesandpurpoesmentionedintheinstrument.NotaryPublicinalJfortheStateofWashingtoniry(Print):L4JLtr-ppointmentexpires:-2-H:\CED\Data\Forms-Templates\SeIf-HeIpHandouts\Planning\TemporaryuseTier1doc05/14 DEPARTMENTOFCOMMUNITYANDECONOMICDEVELOPMENTSUBMIHALREQUIREMENTSTIER1TEMPORARYUSEPERMITCityofRentonPlanningDivision1055SouthGradyWay-Renton,WA98057Phone:425-430-7200(thenpress#4)Fax:425-430-7231A)MasterApplicationForm(completedwithpropertyownersignature/s)andapplicationfeeB)TwocopiesofasiteplanwhichmeetsALLOFTHEFOLLOWINGREQUIREMENTS:1.Includesnameandtypeoftheproposedbusiness2.Descriptionoftheproposedtemporaryuse(discusstimeframeusewilloperate).3.LIDrawntoscale:1”=20’(OranalternativescaleapprovedbythePlanningDivision)4.LIDateandNortharrow:Orientedtothetopofthepaper!plainsheet5.LLotsize:lnsquarefeet6.LILocationanddimensionsofallexistingandproposed:a)Structuresb)Vendor-usevehiclesorotherexteriordisplayareasc)Distanceinfeettopropertylinesd)Refuseareae)Parkingspaces7.jIdentifyand/ordimensionall:a)Businessesonpropertyb)Propertylinesc)Streetsd)Alleyse)Drivewaysf)Sidewalksg)Landscapeareash)Firehydrantsi)Electricallineconnections-,,.,C)OnecopyoftheSeattle&KingCountyHealthDepartmentapproval(forfood/drinkserviceusesonly)H:CED’Data\Forms-Templates\Self-HelpHandouts\Planning\TemporaryUseTier1.doc05/14