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SNOHOMISH ENVIRONMENTAL HEALTH DIVISION
HEALTH 3020 Rucker Avenue, Suite 104
DISTRICT Everett, WA 98201-3900
425.339.5250 FAX: 425.339.5254
Healthy Lifestyles, Healthy Communities
Au-ust 5, 2002
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In Sun Yu
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19418 70" P1. W
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Lynnwood, WA 98026
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Subject: Moa Coffee Shop, (formerly Moldova), 22923 Hwy 99 Suite J, Edmonds
Dear Mr. Yu:
Your plans have been received; however the plans cannot be approved as submitted. The
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following information is needed prior to further plan review.
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1 . Submit a list of equipment noting manufacturer and model numbers for all food service
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equipment including espresso machines, coffee machines, mixers and slush ice machines.
2. Resubmit the model number for the True refrigerator. The number submitted appears to be a
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serial number.
floor
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3. No restrooms are indicted on the floor plan. The restrooms must be shown on the plan.
If customer seating is provided customer accessible restrourns must also be provided,
4. The floor does not show the service counter where the espresso machine, coffee
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machines, mixers and slush ice machines and the like will be. This must be shown on the
floor plan.
5. A handwash sink is required at the service counter and must be shown on the floor plan.
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6. Submit a revised floor plan, drawn to scale, showing location of all equipment, plumbing
fixtures and the like, that includes the required additional sinks and information. The scale of
the drawing should be 1/4 inch equals I foot.
Please note that prior to opening of the new fac ility, after the Health District plan review process
be
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is completed and construction is finished, a pre -operational inspection must conducted.
Please contact me if you have any questions. My office number is 425.339.5250.
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SNOHOMISH ENVIRONMENTAL HEALTH DIVISION
302 RuckerAvenue, Suite 104
HEALTH 0
DISTRICT Everett, WA 98201-3900
425.339.5250 FAX: 425.339.5254
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Healthy Lifestyles, Healthy Communities
August 14,2002
2002
In Sun Yu
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19418 70" Pl. W
PERMIT COUNTER
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Lynnwood, WA 98026
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Subject: Moa Coffee Shop, (formerly Moldova), 22923 Hwy 99 Suite J, Edmonds
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Dear Mr. Yu:
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Your plans have been reviewed with the Rules and Regulations of the State Board of Health, and with
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the policies of the Snohomish Health District. With the addition of the following, the plans are
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approved.
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1. Fruit drinks are indicated on the proposed menu. Fresh fruit and produce require washing prior to
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use. If fresh fruit and produce are to be used then a food preparation sink is required. The sink must
be listed by the National Sanitation Foundation (NSF), have at least one integral drainboard and be
indirectly drained.
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2. Water heaters must be of sufficient size to provide hot water to dishwasher and/or scullery sinks and
hot water to all handwash sinks.
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at the same time provide
3. All food service equipment must be listed by the National Sanitation Foundation (NSF) for its
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intended use. The Dew Thou Samwoo slush ice machine model #SIS-9, the Berrera espresso
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machine model #BZ40, the Emerald Hills coffee machine, and the Ice Box Limited freezer, were not
found in the current NSF or equivalent listings. These units must be replaced with NSF or equivalent
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listed equipment or documentation must be. submitted which demonstrates NSF equivalency.
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Manufacturer nam _s and model numbers for replacement units must be submitted prior to the pre-
operational insl2ectio_n. Submitted manufacturer names and model numbers should be rechecked to
assure the information submitted is accurate.
4. Extra wall protection is required on walls behind sinks, including in the restroom, and food
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preparation tables. A 16-inch high backsplash of plastic laminate, fiberglass -reinforced plastic or
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equal is acceptable. Wall protection behind mop sinks must cover the entire splash zone. Plastic
coated hardboard is not acceptable.
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5. The floor must be surfaced with a durable, nonabsorbent, easily cleanable material.
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6. The ceiling above the food preparation areas must be nonabsorbent, smooth, and easily cleanable.
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7. All light fixtures in food preparation and storage areas must be provided with covers or shatterproof
bulbs.
8. Plumbing must meet state and local codes.
A pre -operational inspection is required prior to opening for business. At the time of inspection the
construction of the food service establishment must be complete and all equipment must be in place.
Incomplete construction may result in a $140.00 reinspection fee. Contact the Food Program office a
minimum of one week in. advance to schedule an appoint menl "is will ensure compliance with the
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Rules and Reettlations of the State Board of Health for Food ce Sanitation.
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FINAL PROJECT APPROVAL FORM
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DATE
MEMO TO: PERMIT COORDINFOR, BUILDING DIVISION
FROM: DEPARTMENT DATE—
ENGINEERING DIVISION DATE—
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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X GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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R I E-INSPECTED OUTSTANDING ISSUES -GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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SETBACKS ...............
FOUNDATION:
Footing......................
wall .........................
Pier/Porch ............
Retaining Wall ...........
Slab Insulation
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Wall Insulation ...........
Ceiling Insulation
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SPECIAL INSPECTION