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CITY OF EDMONDS
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SEPARATE FERMI..,...
STATE SURCHARGE
PERMIT APPLICATION: 180 GAYS
PERMIT LIMIT. I YEAR , PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERM T FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
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ENG, INSPECTION FEE
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FINAL PROJECT APPIR AL FORM
TO:
DATE:-
M[EMO TO: pERmrr COORDINATOR, BUILDING DIVISION
FROM'. FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATE-
7 PLANNING DIVISION DATE
PROJECT__��'k U
SITE ADDRESS
# DATE INSPECTED
PERWT
SPEC
DESCRIPTION OF WORK TO BE IN
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed, Department to the granting Of:
Final approval of the described work
--GRANT FINAL PROJECT APPROVAL
-GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
I
-FAILED FINAL INSPECTION - OUTSTANDING ISSUES
1.
2.
3.
-RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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ENVIRONMENTAL HEALTH DIVISION
S140tiomisti 3020 Rucker Avenue, Suite 104
HEALTH Everett, WA 98201-3900
425.339.5250 FAX: 425.339.5254
DISTRICT
Healthy Lifestyles. Healthy Communities
ApdIll,2000
LACHLANFOSS
WOODMAN CONSTRUCTION
3 LAKE BELLEVUE DR #201
BELLEVUE WA 98005
Subject: Proposed, Remodel QFC, 22928 100th W. , Edmonds
Dear Mr. Foss;
Your plans have been reviewed with the Rules and R gulations of the State Board of Health, and with the
policies of the Snohomish Health District. with ie gition of the following, t 7e �lans are approved.
nk is required.
1 . No designated handwash sink is shown at the front counter at the bakery. A handwash si
2. only one handwash sink is shown at the service dell. It is currently in a central location in the deli with
The north end of the service counter had limited
wide isle ways to the sink from the front counter.
handwash sink access. The one handwash sink will be acceptable at this time. If, however, future routine
inspections indicate that employees at the deli service counter are not using the handwash sink, an
additional handwash sink will be required at the dell service counter.
vertical partition 16 inches in height is required
3. A horizontal separation of at least 16 inches or a
between the east food preparation sink and the east handwash sink in the meat preparation area.
artition 16 inches in height is required
4. A horizontal separation of at least 16 inches or a vertical p
between the food preparation sink and dishwash area of the service deli.
5. A horizontal separation of at least 16 inches or a vertical partition 16 inches in height is required
in the produce area.
between the food preparation sink and handwash sink
National Sanitation Foundation (NSF) for its intended
6. All food service equipment must be listed by the
Use.
rators must be listed for the storage of potentially hazardous foods.
7. Storage refrige
8. Extra wall protection is required on walls behind sinks and food preparation tables. A 16 inch high
backsplasla of plastic laminate, fiberglass reinforced plastic or I equal is acceptable. Floor to cell"rig
protection is required on wall behind dishwashers.
9. The floor must be surfaced with a durable, nonabsorbent, easily cleanable material.
st be nonabsorbent, smooth, and easily cleanable.
10. The ceiling above the food preparation areas mu
tion and storage areas must be provided with covers or shatter proof
11. All light fixtures in food prepara
bulbs.
12. Plumbing must meet state and local codes.
ire
13. The ventilation system shall be installed and operated to meet applicable building, mechanical, and f
codes. st barriers must be installed to
14. If the establishment continues to be in operation during the remodel, du
ompromised. The restaurant will be required to
ice occurs, due to the remodel.
ensure that food protection and safety is not c
discontinue operations if any disruption in water, electrical, or sewer sery
le and functional during all hours of food service
st be kept accessib
Proper handwash stations mu
establishment operation.
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Subject: Proposed, Remodel QFC, 22829 100th W. , Edmonds
April 11, 2000
Page 2
A preoperational inspection is required prior to opening for business. At the time of inspection the
e in place.
construction of the food service establishment must be complete and all equipment must b
Incomplete construction may result in a $130.00 reinspection fee. Please contact the Food Program
office a minimum of one week in advance to schedule an appointment. This win ensure compliance
ith for f;od ServL
with the Rules and Regulations of leTtZ ioiLW14ei [th for Food Service Sg!1u2n.
If there are any significant changes or additions to your layout or equipment, ute
District must be notified.
Please contact me if you have any questions. My office number is 425.339.5250.
Sincerely,
4 Z.ber' H
,n..ni�e
R14/sm.
cc: City of Edmonds Building Department
QFC, Inc., owner
Jeanette Murphy, Food Safety, QFC
Jeannie Ness, Food Safety, QFC
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Sent By: WOODMAN CONSTRUCTION; 4254546918; Mar-24-00 11:28AM; Page 2/2
WOODMAN CONSTRUCTION, INC.
3 Lake Bellevue Drive, Suite 201
Bellevue, Washington 98005
(425) 454-3621
Mr. John Allen
QFC Facilities
3663 1" Ave S
Seattle, WA 98134
March 17, 2000
Re: QFC - $51 Edmonds
DcarJobn:
This is to confirin our telephone conversation on this date whereby you authorized
m cfion,on
Woodman Construction, Inc, to proceed with preparations to coin cncc constru
V NNE
the above rderenced project, for the agreed upon price of THREE I 11)N r)RED FIFT
THOUSAND 111ORTY Tiime Dollars ($359,083.00) plus WSST.
I will keep you informed as to the permit status as that information becomes available.
If I can provide you with any additional information please feel free to contact me.
Sincerely,
9cl "g lin
00DMA� CONSTRUCTION INC;
Enclosure
CWA) W0A)MMCWG?0G
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
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FINAL APPROVAL FOR
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LEE PERMIT 2DO loq
CITY OF EDMONDS
NUMBER _
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CONSTRUCTION PERMIT APPLICATION
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY 111111, Ally CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 1601DAYS
PERMIT LIMIT. 1 YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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AIPLITA.T ON BEHALF OF HIS OR HER SPOUSE� HEIRS, ASSIGNS AND SUCCESORS
END, INSPECTION FEE
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IN ITIREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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ED'MONDS� WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
F WHATEVER NATURE. ARISING DIR
ALL CLAIMS FOR DAMAGES 0 E
OF THI PERMIT SHALL NOT BE
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE
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PLAN CHECK
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NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ROMANCE PROVISION.'
TOTAL AMOUNT DUE
RECEIPT
I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION; THAT THE INFORMATION
A PLICATION APPROVAL
GIVEN IS CORRECT. AND THAT A M THE OWNER. OR THE OULY AUTHORIZED AGENT OF
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THEOWNER IAGREETOCOMPLY ITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
1,11 1pltY:lldFl.l0l'd.
TION AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
1 4 VI'6LATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING To FOR INSPECTION
WORl"EN'l COMPENSATION INSURANCE AND FCW 11,11, g YRE DATE
1 (425) j 7/u3
1 1 1 _ve." RIL21Y DATE
EXT 333
/"ATTENTION 1 --s 01 Q)
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL - FILE - YELL. - IlSlkT.R
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- FAX PINK -OWNER, COLD ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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