22931 HWY 99 STE F_Redacted11111111r ZZ 9 31 1-i_rf qW qy 9 Yri: F
CITY OF EDMONDS
r BUSINESS LICENSE APPLICATION — COMMERCIAL O Building
n Engineering
FEE: $125.00 ❑ Flie
CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION n Plenrirfl
I•H U Police
121 5 AVENUE NORTH, EDMONDS, WA 98020 PHONE 425.7752525
OFFICE USE ONLY
BL.#
Customer#. 'SIC
I Yea
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INSTRUCTIONS: Please complete the application -In full and attach the required floor plan: Middle Initial or name roquired of all parties concerned. If no
middle name, please Indicate by writing NMN. Sign and return application with fee.- Please advise of any change In status. New license. required if
business changes location or ownership,Notification to City of Edmonds ro-quirsd if business closes. License expires 0ecembor 31" each yeas Renewal
must be submitted prior to January 31" to avoid late fees. r
BUSINESS NAME EUROPEAN FOOD /
BUSINESS. 22931 HIGHWAY 99 EDMONDSVI_IA 98026-8A68 UNIT "F"
Strw Sylto N City; State;-Wp,Code
MAILING ADDRESS 8128 200th ST SIN EDMONDS VVA 98026-6733
Stmot or PO Box H: Sulte d City; StaterZIP Code
BUSINESS PHONE( 425 1954-5314 WA STATE. TAX ID p (UBI) 6, 0: 3 Q %, 3 f
BUSINESS E-MAIL Corner.alex(Mgmail.001r' BUSINESS WEBSiTE'
BuslNEss OWNER r MAIN CONTACT ALEXANDR CUCEROV l 425) 954-5314
Name Phone Number
PROPERTYOWNER; CINDY RYU dba RYU c/o JUN RYU t, 206, 200-8668
Name Phone Number
EMERGENCY NOTIFICATION.(For Premise Access in Emergency): 1'
CUCEROV ALEXANDR NMN r 425 , 954-5314.
Cast Name First Name MI Phone Number.
1._ 1
Last Name First Name Mt Phone Number
NATURE OF EUSIN=SS (Provide a Detailed Descrlpfion of BuNness'Activitios. Products s service,); GROCERY RETAIL STORE
SPACE ALTERATIONS TO BE MADE: YES_NOX DESCRIPTION
PREV)OUS BUSINESS AT THIS ADDRESS EUROPEAN FOOD
"U MBE E — - ... -.: SQUARE FOOTAGE OF BUSINESS SPACE 950, so.4l
rN UMBER�OF�E�,v�iPLOYEE S-:_---
TYPE OF BUSINESS -PLEASE CHECK APPROPRIATE CATEGORY:
CONSTRUCP..ON
G FINANCE, INSURANCE, REAL ESTATE
u LANDSCAPE, HORTICULTURAL
Ci MANUFACTURING
❑ NON-PROFIT
RETAIL
u SECONDHAND DEALER
M SERVICES
L2 WHOLESALE
D OTHER
PROPOSED CPENING,UA1't5 05/0112016
BUSINESS HOURS: 8 AM.- 8 PM
DAYS OPEN.'
SUNRAY
VWEDNESIDAY
MONDAY
THURSDAY,
TUESDAY
FRI&AY'
xSA
I'URUAY
X
AMUSEMENT DEVICES ON PREMISES7YES NO�_$F YES, TOTAL:NUNBER' LIQUCR SOLD.dN PREMISES?.SYENt3�
GAMBLING? YES_ NO Y CIGARETTES: SOLD ON PREMISES? YES NO—X—
FLAMMABLE OR HAZARDOUS MATERIALS USED OR S70R577 YES- NO_X_ IF YES, PLEASE PROVIDE A UST OF MATERIALS AND QUANTITIES:
PARKING SPACES ON SITE: TOTAL SPACES- 3 ACCESSIBLE SPACES FOR FANDICAP PARKIAG_X
DOES THE BUSINESS CONTAIN AN =_NTRAKCE ACCESSIBLE TO PERSONS WITH DISABILITIES? YES—x_ NO
APPLICANT
NAN.E ALEXANDR CUCEROV
Printed Name Si attire
TITLE- Mr:. - DATE 0412212016,
Off- �Iq
NAME
LAST FIRST NGDLEINTW,
ADORESB
STREET 5UTEJAPTIUNTa CRYISTAT IPCODE
LICENEEORID04STAIE
PARTNERSHIP — PARTNER 1
NAME
LAST FIRST MIDDLE INIM•_
ADORESB-
STREET WffSAPTA#4TR CRYIETATEar CODE
HOME PNON I
I DRNERSUCENSECRION85TATE
DATE OF BIRTR
'WY9TATE Of BRTHDOUMRY OF BITRN
PARTNERSHIP— PARTNER 2
NAME.
LAST FIRST MIUM-E INRIAL
ADORESS
STREET $T C"AFTATEOPCODE
HOME pNONE
I OTHER'S LNFNSE OR®FS STATE
OATEOFBOn%
C"ORAMOda,BROI C OFB MON
- - CORPORATIONI LLC 4r PLLC
"
NAME OFCORPCMATIDN CORNER PH.D LLC FEDERALTA%ON 81-2234237
/
GORP.ADCRESIS
8128 2001h ST SW EDMONDS. WA 98028$733. ( 1
good WM.Aa:. UNLM City, Santa Emd Lp Caoe Pown NvmEer
CORPORATE OFFICERS:
Lag Name
PIRL Name M TOO (.W` MNie. _
CUCERCV
ALEXANDR NMN Mr... 02111 I1961
LOCALGONTAOT
CUCEROV ALEAANDR NMN Mr. 0211111961 _
LW Nome FM Name MI The DaNtI
( 425 1 954-5314
p"Wo Paou.N.meN -
elv USSONLY:
BUILDING DEFT.
0 APPROVE
DNApmcW CRTE
NI
OCCUPANT LORD
BULDINGPERNR .
OCCUPANCY
ENSINEMNO Cl aPPROVE O. DISAPPROVE DATE 9GNATWtE
RREDER. Cl APPROVE M DIBMPROVE DATE SIGNATURE
PLANMNO DER. Q aoPro E 0 DISAPPROVE DATE -S.XNATURP
ZONNGCOW CCNOITIONALMEPERMIT COMMENT
POLICB NOT. LI AWKIVE Q DISAPPROVE DATE SIGNATURE
Quan, Susan
From: Alex C <corner.alex@gmail.com>
Sent: Saturday, April 23, 201610:56 PM
To: Business License mailbox
Subject: License Application
Attachments: Commercial_Business_License form 04.16.2015_signed.pdf; BUILD FLOOR PLAN .jpg;
COMMERC FLOOR PLANjpg
To whom it may concern.
Three files are attached:
1. Commercial Business Licence Application;
2. Building Floor Plan;
3. Commercial Floor Plan.
For any questions my phone N2 425-954-5314 (Leave a voice message please and I'll call back) or email me.
Sincerely,
Alexandr Cuceiov.
Commercial Floor Plan
e48,.
Countertop and Storage Cabinets
Refrigeration
ier's countertop IShowase
?ref. Ref.
Display Display
Refrigeration
Showcase
Retail Merchandise
860 sq.ft.
Display sheifs 5 feet. high
Business Name: European Food
Tipe of Business: Retail Food Store
Total Aria of Tenant Space: 950 sa.ft.
Previous Business Use: The Same. No Changes.
Worktable
.Freezer
Workroom
96 sq.ft.
Refrigeration
Showcase
L
Display shelf
Refrigerator
Fire Extinguisher
Existing Floor Plan - no changes to be mad.
Serving Brier, Edmonds, and
Mountlake Terrace
DISTR"09"T www.FieDistricti.org
LOCATION:
22931 Highway 99 98026
BUSINESS NAME:
European Food, LLC
MAILING
ADDRESS:
22931 Highway 99, Edmonds, WA 98026
BUSINESS OWNER: f� /
EMERGENCY-1:
KEY ACCESS-2: KG&yok-,k4na nn
EMAIL: > ",p P .61SPX CU �vr�4i�r � y1
v
PERSON CONTACTED: D Vhulc
NAME OF INSPECTOR:
FIRE SYSTEMS: FE 5/13 FC SA
FIRE PREVENTION
12425 Meridian Ave S
INSPECTION REPORT
Everett, WA 98208' '"- '
❑ ❑BEDMORIER S
RIER
Phone (425) 551-1200
❑ MOUNTLAKE TERRACE,
Fax (425) 551-1272
[3 UNINCORPORATED '
PHONE: 4257712001
HOME PHONE:
FREQUENCY I STATION & SHIFT
20-C
SCHEDULED
DATE DUE 'Apr 2016
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HOME PHONE: lo? (J / S_L
CURRENT
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BUSINESS
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INITIAL I V�SFjECJI rDAT�
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I AGREE TO,'CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
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CONTACTED:
CONTACTED:
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INSPECTOR:
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INSPECTOR:
INSPECTOR:
DATE:
DATE:
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3
VIOLATIONS
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PRE -CITATION
CITATION ISSUED
1 5
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LETTER SENT
NUMBER: ._.
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CODE
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2 6'
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DATE:
SECTION:
RETURN RECEIPT
3
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3
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RECEIVED
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DISPOSITION:
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DATE:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES _ ❑ NOT
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FIRE PREVENTION
CO.
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH
����
: •• ,.
Mountlake Terrace;and
1 ,, ,, . • � �
Everett, WA 98208
1- ❑ EDMONDS
❑BRIER
the Town of Woodway
�T
Phone (425) 551-1200
❑ M O NT AY
TERRACE
ST
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www FiYeDistrictl. org
Fax (425) 551-1272
❑ UNINCORPORATED
❑UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION:
22931 Highway 99
366
20 D
BUSINESS NAME:
European Food, LLC
PHONE: 4257712001
SCHEDULEDDATE DUE ► 04/01/13
MAILING
22931 Highway 99
UFIR ► 516 4 056
I
ADDRESS:
Edmonds
90026
BUSINESS OWNER:
Kosyuk, IPina
HOME PHONE: 2060199260
ACTIVE e.
EMERGENCY-1:
py Cindy
� ��, �y
2063622692
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS ❑
LICENSE
PERSON CONTACTED:
3
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE
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SYSTEMS:
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ANNUAL
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSIO�i
GRANTED 7Ypo
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
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NUMBER:
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CODE
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RETURN RECEIPT
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DATE:
DISPOSITION:
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LETTER NEEDED ❑ YES NO
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8
FIRE DEPARTMENT COPY
' �•
FIRE PREVENTION
Ser-ving Br'rer; •Edrr1o11LIS
12425 Mer•idiarJ Ave S
INSPECTION REPORT
SNOHOMISH CO. i
`+ Ter•race,and
TIRE
Everett, WA 98208
EDMOMountlake
❑BRIER s
❑RIER
` �
DISTR T the Townof Woodway
Phone (425) SSI -1200
❑ MO AY
❑ OUNTLNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) SSl -1272
❑ UNINCORPORATED
LOCATION: 22931 Highway 99
FREQUENCY STATION & SHIFT
366 20 C
1
BUSINESS NAME: European Food, LLC
PHONE: 4257712001
SCHEDULED 04/01/12
DATE DUE ►
MAILING 22931 Highway 99
UFIR ► 516 4 056
ADDRESS: Edmonds
90026
1 BUSINESS OWNER: Ko yuk, {Tina
HOME PHONE: 2068199268
ACTIVE
EMERGENCY-1: Ryu, Cindy
HOME PHONE: 2063622692
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
'
PERSON CONTACTED: a( &j P
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
6"1��
FIRE
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ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
3
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE: _...�
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
$
4
$
DATE:
DISPOSITION:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
�St 1gg0
a
LOCATION: 22931 Highway 99
4
BUSINESS NAME: European Food, LLC
MAILING 22931 Highway 99
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257712001
ADDRESS. Edmonds 98026
BUSINESS OWNER: KQsyuk, Irina HOME PHONE: 2068199268 ACTIVE
EMERGENCY-1: RyU, Cindy HOME PHONE: 2063622692
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION & SHIFT
366
20 R
DATEEDUEE ►
04/01/11
UFIR ► 516
4 056
PERSON CONTACTED: INITIAL INSPECTION DATE
TH
NAME OF INSPECTOR:
FIRE FE ! Itl
SYSTEMS: m A fvJAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE ►
VIOLATION CODE
2
2
3
3
4 "
4
5
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5
6
6
7
7
8
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1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
2 6
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
DATE:
CODE
SECTION:
'
5! "
3
7
3
7
RETURN RECEIPT
RECEIVED
^�
6/ /
4
18
4
8
DATE:
DISPOSITION:
8
LETTER NEEDED YES NO
LETTER NEEDED 0 YES [] NO
FIRE DEPARTMENT COPY
CITY OF EDMONDS.
121 5TH AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-02151.
FIRE DEPARTMENT
Fst. 18g�
LOCATION: 22931 Highway 99
BUSINESS NAME: European Food, LLC
MAILING 22931 Highway 99
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257712001
ADDRESS: Edmonds 98026
BUSINESS OWNER: Kosyuk, Irina HOME PHONE: 2068199268
EMERGENCY-1: RyU, Cindy HOME PHONE: 2063622692
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION & SHIFT
366
20 A
SCHEDULED
DATE DUE ► 04/01/10
UFIR ► 516
4 056
ACTIVE
PERSON CONTACTED: '[A" �"--lN f'( k' cx"O)) ON I Y INITIAL INSPECTION DATE
NAME OF INSPECTOR: Ku I -,hi
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SYSTEMS:
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DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
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CONTACTED:
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INSPECTOR: ��/ie
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DATE: aJ b / (7
DATE:
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D VIOLATIONS
1 5
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1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION: _
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
7
4
8
4
8
DATE:
DISPOSITION:
8
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
FIRE DEPARTMENT COPY