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6732 BEVERLY BLVD 2019-01-17
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6732 BEVERLY BLVD 2019-01-17
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Last modified
1/17/2019 1:48:42 PM
Creation date
1/17/2019 1:48:41 PM
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Address Document
Street Name
BEVERLY BLVD
Street Number
6732
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" _SNOHOMISH <br /> -.-Ai HEALTH wwwsNOHQ DISTROIRG CT <br /> Remodel/Revision Plan Review Checklist <br /> Facility name: - v CCV2MC ? <br /> This checklist will help you prepare a complete plan 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 /> ***REQUIRED*** <br /> ✓ ITEM DESCRIPTION Only <br /> Intake <br /> Er1 Application Provide complete application. <br /> 2 Scope of work Provide a scope of work. <br /> I ] 3 Fee Include application fee. <br /> ***REQUIRED ONLY IF APPLICABLE*** <br /> Office Use:;: <br /> ✓ ITEM DESCRIPTION Only <br /> Intake <br /> 4 Open During Remodel Provide complete Open During Remodel questionnaire. <br /> questionnaire <br /> n 5 Floor plan Provide proposed floor plan with original floor plan. <br /> I OR <br /> Provide demolition plan. <br /> I' 1 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 food and beverages you will <br /> be serving/selling. <br /> I 8 Food preparation steps Provide description 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 /> 9 Supplemental questions Provide complete Supplemental Question form(s)if applicable. <br /> (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 operating permits and have been inspected and approved by all applicable city, county and state <br /> agencies. <br /> Signature/Title Date <br /> • <br /> Environmental Health Division <br /> 3020 Rucker Avenue,Suite 104 e Everett, WA 98201-3900 ■ fax:425.339.5254 ■ tel:425.339.5250 <br />
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