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SNOHOMISH <br /> Fts HEALTH DISTRICT <br /> irT:,,tw, Remodei 1 Revision Ran Review Checlldist <br /> '44.•-•-....t*t WWW.SNOHD.ORG <br /> FacIlIty name: 'QUAL ; .1_ <br /> — '••• <br /> This checklist will help you prepare a complete-,,lan review packet. Submit the completed plan review packet and signed <br /> checklist with the required application fee.Incomplete plan review packets will not be accepted. Make a copy of this plan <br /> review packet for your records prior to submittal. Plan review fees are non-refundable. <br /> 4" I <br /> 0f1The Use <br /> ITEM DESCRiPTiON - <br /> - <br /> - Intake,: <br /> - <br /> __ - _ - _ <br /> / 1 Application Provide complete application. - <br /> — _ <br /> _ <br /> v' 2 Scope of work Provide a scope of work. - <br /> LV 3 Fee include application fee. <br /> ***REQUIRED ONLY W APPLICAILE' <br /> Office Use <br /> i ITEM DESCRIPTION Only <br /> Intake <br /> - <br /> 111 4 Open During Remodel Provide complete On n iuring Remodel questionnaire. - - <br /> - <br /> NE questionnaire - - <br /> Et 5 Floor plan Provide proposed itoor plan with original floor plan. <br /> OR - <br /> - _ <br /> _ <br /> Provide demolitiva plan. <br /> - - <br /> 6 Equipment list Provide make and model numbers of all new equipment.Show <br /> location on floor plan. Only commercial grade, National Sanitation <br /> Foundation (NSF)or equivalent,equipment is acceptable. -- <br /> 7 Menu Provide a detailed menu of all the fowol and beverages you will <br /> be servingiselling. _ <br /> 8 Food preparation steps Provide descripti en of how the new menu items will be <br /> prepared.Include how each menu item is obtained,stored, and <br /> prepared. Describe process of cooking,cooling, reheating,and hot <br /> holding,if applicable. <br /> II9 Supplemental questions Provide complete Supplemental Question form(s)if applicable. <br /> I , (catering and food processing) <br /> I understand I cannot make any changes to this food establishment until I have received written approval from this program, <br /> obtained all annual operatin mits and have been inspected and approved by all applicable city, county and state <br /> ..- <br /> ,-- <br /> ,/ kit_ 4. <br /> Signarri <br /> turetle Date OV Z-g/b1 <br /> ta <br /> Envir*nmerntoil Reath DivIstion <br /> 3020 Rucker Avenue, Suite 104 El Everett, WA 98201-3900 n i'ax:425.339.5254 11 (el:425.339.5250 <br />