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Home My WebLink About624 Broadway_BLD004322_2025INSPECTION REPORT Lf4liN PermitNo.: (10 -'l� .S12-1#: Address:GA,y 1-f L r,,r1 Contractor:ODate: `4-APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. lo I- Inspector:Date:,( ��44&� _ TYPE OF INSPECTION REQUESTED ❑ Under -floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough -in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation 17 Other: L,n A,, Z_ ;,- 301NSPECTIOIN REPORT DN Permit No.: ' �- ^' it-.0—til Address:r CrIC Owner:G Cr 2 - PPROVAL El PARTIAL APPROVAL 6 VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. " ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. Inspector: Date: YPE OF INSPECTION REQUESTED ❑ Under -floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough -in -�K Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: *NG INSPECTION REPORT — TQ Permit No.. Lot #: Address: r"r� aG't • �3 - 7� 2 2 Contractor: 11 �O Owner: 4IN O Date: 'APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. Inspector: ❑ Undef-floor ❑ Footing ❑ Foundation ❑ Mechanical ❑ Wood Stove ❑ Masonry ❑ Other: E OF IIPECTION REQUESTED ❑ raming Drywall, Nailing El Shear Nailing ❑ Grid CJ Rough -in LJ Drainage ❑ Gas Piping ❑ Consultation ❑ Groundwork ❑ Struct. Slab ❑ Final ❑ Insulation INSPECTION REPORT Permit No.: #: 4- 'O Address: A/ " Contractor: 0 Owner: %% s `INO� Date: 1l-17- 00 - PPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. Inspector: Date: TYPE OF INSPECTION REQUESTED ❑ Under -floor ❑ Footing ❑ Foundation ❑ Mechanical ❑ Wood Stove ❑ Masonry ❑ Other: ❑ Framing ❑ Drywall, Nailing ❑ Shear Nailing ❑ Grid ❑ Rough -in ❑ Drainage ❑ Gas Piping ❑ Consultation ❑ Groundwork ❑ Struct. Slab ❑ Final Insulation INSPECTION REPORT � N G �O Permit No.:,Co— Lot #: Address: `t !V 0 A f � } �• n-3 -q-9:2- ' � Contractor: _ �O Owner: IN Date: APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. Inspector: 2 Date: //- %-j—' ❑ Under -floor Footing ❑ Foundation ❑ Mechanical ❑ Wood Stove ❑ Masonry ❑ Other: E OF INSPECTION REQUESTED ;��Framing ❑ Gas Piping ryw all Nailing❑ Consultation ❑ Shear Nailing ❑ Groundwork ❑ Grid ❑ Struct. Slab ❑ Rough -in ❑ Final ❑ Drainage ❑ Insulation City of Arlington o '341N�' Katherine L. Cherrier Bank of America 501 N. Olympic Ave. Arlington, WA 98223 RE: Assignment of Savings Account/Certificate of Deposit Acct. # 13591508 — Your Daily Grind Espresso Dear Katherine: This letter is to authorize the release of the above noted assignment of funds. All landscaping as required for this project has been installed, inspected and the City Engineer Paul Richart has authorized release. If you should have any questions, please contact me at 360.402.3503. Respectfully, Cristy . rubaker Public orks Coordinator Cc: File Frank DeGraff 238 North Olympic Ave. 01� �o OX' 801 Arlington, WA 98223 NOV-17-2000 FRI 03:59 PM BAILEY,DUSK[N & PEIFFLE FAX NO, 360 435 6060 ASSIGNMFNT Ole SAVINGS ACCOUNT/CERTIFICATE OF DEPOSIT P. 02 *Ot, �Fn ,q,�L,; 1 The undersi(med has the following per it anolication or development approval pending with the City of Arlington, Washington: The terms of the City's approval of said Project a , iticorporatc herein by this reference. 2. This assignment atislies the requirement of bonding for the following requirements of the City of Arlington: 3. The undersigned does hereby assigtransfer, and set over to the City of Arlington all };ght, itic and interest to the su of S� , which is presently held in t dank, , ,17� � branch, Account 4. if the undersigned fat fully performs all oFthe above obligations described in paragraph (2), above, and has demonstrated to the satisfaction of the City of Arlington that any and all laborers, mechanics, materialmen, subcontractors assisting in the completion of the requirements above described have been paid, then this agreement shall be null and void and the City of Arlington shall release the aforementioned funds. 5. TFthe undersigned, upon written demand by the City of Arlington and at least 14 days' prior notice, fails to complete the requirements as set forth in paragraph (2), then the City of Arlington may, in its discretion, withdraw said funds described in paragraph (2) for the purpose of completing the work above described, Any such action by the City of Arlington shall not release the undersigned from liability, and the undersigned agrees that it shall remain responsible for all costs incurred by the City of Arlington in completing; the tasks described in paragraph (2), above, less any sums withdrawn pursuant to this paragraph. G. This agreement shall be binding on the undersigned and on their successors and assigns. DATED: s 1�Ilaturc ACCEPTANCE The undersigned hereby accepts the foregoing Assignment of Savings Account/Certificate of Deposit, Account or Certificate No. 11.r. in the amount of Sp+� �, and agree to abide by its terms. DATE: `/:V'Q6 C Bank Branch -TQSNOHOMISrI HEALTH DISTRICT November 15, 2000 Chanda Dorsey 24923 Jim Creek Road Arlington, WA 98223 ENVIRG-rv,AENTAL HEALTH DIVISION 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 425.339.5250 FAX:425.339.5254 Healthy Lifestyles, Healthy Communities RECEIVED NOV 17 2000 CITY OF ARLINGTON Subject: Proposed, Your Daily Grind Espresso, 624 North Broadway Street, Arlington Dear Ms. Dorsey: Your plans have been reviewed with the Rules and Regulations of the State Board of Health, and with the policies of the Snohomish Health District. With the addition of the following, the plans are approved. 1. A copy of the proposed menu must be submitted. 1. The food stand sink must be a counter top unit. Under counter rollout handsinks are not acceptable. Handwash sinks must be provided with hot and cold water. A holding tank system for fresh water and waste water for the hand sink is acceptable. Waste water tanks must be 15 percent larger than the fresh water tank. If hard plumbed water is supplied to the food stand then a hard plumbed connection to sewer must also be provided. 2. All light fixtures in food preparation and storage areas must be provided with covers or shatter proof bulbs. A preoperational 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 $130.00 reinspection fee. Please contact the Food Program office a minimum of one week in advance to schedule an appointment. This will ensure compliance with the Rules and Regulations of the State Board of Health for Food Service Sanitation. If there are any significant changes or additions to your layout or equipment, the Snohomish Health District must be notified. Please contact me if you have any questions. My office number is 425.339.5250. S ncere� � Rob rt A. oppa, R.fi: Environmental Heath Specialist RH/ek cc: City of Arlington Building Department ';i�.1NGp j �Sir�xt:. CITY OF A RU I NGTON CONSTRUCTION 1F3-aRM I T PERMIT No- o O O —43 22 Owner: DEGRAFF, FRANK 24923 JIM CK RD ARLINGTON 98223 Value of Work: $10,000.00 Tax ID: 46180070010000 Phone: 206-890-5192 Describe Work: ESSPRESSO STAND Proposed Use: ESSPRESSO STAND Legal Description: Job Address: 624 NORTH BRODWAY Contractor's Naee Type Address License# FRANK DEGRAFF OWN 24923 JIM CREEK ROAD TOTALS Fee Pereit Fee $250.00 TOTALFEE ................. $250.00 PAYMENTS.................. $350.00 TOTAL DUE.................-S100.00 DATE �/, 2 00 RECEIPT # /6-Fd3 CITY OF ARLINGTON 238 N. Olympic Ave. Arlington, WA 98223 (360) 435-5785 SISNATURE: I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED.THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS LAWS AND ORDINANCES GOVERNI THIS TYPE OF WORK WILL BE 0MP ED TH WHETHER SPEC4ii ED UILD;4G OFFICIAL RECEIVED ****THREE HUNDRED FIFTIYbOLLARS"& 00 CENTS RECEIPT No. RECEIVED FROM DATE REC. NO. AMOUNT YOUR DAILY GRIND ESPRESSO 1i/07/00 15803 FRANK DEGRAFF 350.00 CHECK MISCELLANEOUS RECEIPT COUNTER 9.00.01.00 Standards Sta.w inning 5.89.02 Land Use Permit Processing 15803 REF. NO. 1711 C ITV OF ARL I NOYON COMO-r RUCTION RE RM I T RE RM I T NO-2 00-43a2 Owner: DEGRAFF, FRANK 24923 JIM CK RD ARLINGTON 98223 Value of Work: $10,000.00 Tax ID: 46180070010000 Phone: 206-890-5192 Describe Work: ESSPRESSO STAND Proposed Use: ESSPRESSO STAND Legal Description: Job Address: 624 NORTH BROD'WAY Contractor*s Name Type Address License# FRANK DEGRAFF OWN 24923 JIM CREEK ROAD TOTALS Fee Permit Fee $250.00 TOTAL FEE ................. $259=00 PAYMENTS .................. $358.00 TOTAL Imo ................. DATE RECEIPT # /StTo3 SIGNATURE I HEREBY CRTIFY THAT I HAV REA D AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS LAWS AND ORDINANCES GOVERN, THIS TYPE OF WORK WILL BE OVIP ED ' TH WHETHER SPEC4FA ED ILDr OFFICIAL CITY OF ARLINGTON 238 N. Olympic Ave. Arlington, WA 98223 ■� - (360) 435-5785 RECEIPT No. 15803 r - RECEIVED � *'***THREE HUNDRED F IFTY DOLLARS° `& 00 CENTS M RECEIVED FROM 1 U. YOUR DAILY GRIND ESPRESSO FRANK DATE REC. NO. AMOUNT REF. NO. 11/07/00 15803 m DEGRAFF 350.00 CHECK 1711 ` In a MISCELLANEOUS RECEIPT N COUNTER I 002.389.00.01.00 Standards uo.uu Planning 001.345.89.02 Land Use Permit Processing 001.389.00.04 Direct Deposit 001.341.50.01 Maps & Publications Building 001.322.10.00 Building 3&Ct 001.345.83.00 Plan Check Fee 001.386.00.01 St. Bldg. Code Fee Miscellaneous 001.341.60.00 Copy Fees 107.002.344.85.00 Trip Generation Mitigation 107.003.345.85.00 Parks Mitigation 107.003.345.85.02 County Parks Mitigation 107.006.345.85.00 Arlington School Mitigation 107.006.345.85.00.01 Lakewood School Mitigation 103.343.83.00.00 Surface Water System Dev. fee Total Receipts $ C:1...%sheff kpsulrs bar codes 8= 0 n 71 t� 0 I I I CA t v l G I ss I I mouxa�{ G�ravCtR act ,� ccT 5�ru�5 oZc�. �--• $Xly f 3oal, z r I Scc. +Nurrc i I I 1! 'ZI l,-r trIc 10'`-XIDI, h �alC. Cell If bs ' ;qQ 4_t 0 Nib pv i Xtl E"4y ChCLVV deLl D a I"-; V);/ P ' ('0 F I V E D N 0 3 7W Q I-." X L4 C%,Ck C"Ir CL Ll ILL LL 0 ! � f ti r �; OFP.. �_ �� _a E iE Ea 2000 x re: ry _%ems__ _ 74:�2 lo� I —fl -7Z-O -rA -? &6 - q 5 S- - &ZOO Q-- Me RECEIVED 2000- y j SNOHOMISH ENVIRONMENTAL HEALTH DIVISION HEALTH Food Program �= �3{}20 'Rucker Avenue, Suits 704 DISTRICT Everett, WA 98201-3900 425.339.5250 Fax:425.339.5254 Healthy Lifestyles, Heald }i communities APPLICATION FOR FOOD STAND CONCESSION, MOBILE. FOOD VEHICLE, LIMITED GROCERY OR INSPECTION WITHOUT PLAN REVIEW PROPOSED ESTABLISHMENT: r (ntime) Food Stand Concession _ 71 Mobile Food Vehicle (locatio dd ss) ❑ Limited Grocery ❑ Reopening Existing (city) Food Service Establishment �1 W (Z1p) OWNER OF ESTABLISHMENT:re- rp� /�f Ott ✓ (Warn f telephone) (address (state) (zip) CONTACT PERSON: J'6e --%D-3— 72�r-7 (for plan review purposes) (name) �. (telephone) (addres ?Gilt`' (city) (state) (zip) —4-� COMMISSARY NAME 1 LOCATI `. /7* TdQeil&e%V, (Name, street address, and city) r , COMMISSARY Public COMMISSARY Sewer WATER SUPPLY: (nafrie of system) SEWAGE DISPC]S .. ❑ Private Well gn DESCRIBE ESTABLISHMENT OPERATIONS: (include hours of operation) c "&- � 2/"z "llaw— Z'e�- Inspection. is basedupon requirements of WAC 246-215, Rules & FOR OFFICE USE ONLY Regulations of the State Board of Health for Food Service Sanitation. PI i i--.4 .195 , 0o Other agency approvals requisite to your operation may include County TOTAL .1.97,.06 or City Planning, Building, Plumbing and Fire Departments, Water and :i t off, 60 Sewer Utilities. C. HH14G;F 0.00 SEE C N'T' FEE SCHEDULE TTEM I.'1.-ii,7-('r + �44i�iii11;;f ;'•1 �'� :! � � �- �_ f SIGNATURE OF APPLICANT DATE SNOHOMISIf Environmental Health Division HEALTH Food Program 3020 Rucker Avenue, Suite 104 DISTRICT -" Everett, WA 98201-3900 Phone:425-339-5250 Fax:425-339-5254 APPLICATION FOR F+C)� Ib- SERVICE FOOD TAND CONCESSION/ MOBILE FOOD VEHICLtiE/ COMMISSARY PERMIT s Establishment Name Telephone # Manager Establishment Street A s Owner Home Phone mil/" rr -5 QA, - bp, rn, Fssttabllis ent City J 21P Establishment Operation Days & Ho (Months if seasonal) Mailing Address (If different from tate Change in ownership? Please check the box and fill in the necessary information on the back of this application. Permits are NOT transferable. Permits valid through December 31. Permits issued on or after September 1' will be charged one-half total annual per 'fi fee. x ,2va� Signature Date FOOD STAND CONCESSION/ MOBILE FOOD VEHICLE/ COMMISSARY CATEGORIES: Check which applies, complete the application, and submit the original, color -coded application with correct fee per the fee schedule. Also include any other required information such as commissary and itinerary letters. COMMISSARY N O V ( 20OG FOOD STAND CONCESSIONS) ,,►' u `= Commissary: r, amcm a comaussaay letter MOBILE FOOD VEHICLES) Commissary: u £co+'n*'n4«Yy/itlnerdry letter License number(s): TOTAL AMOUNT ENCLOSED FOR HEALTH DISTRICT USE TiITHi 1Fi O - 0 0 C.4TFi4ri CA W C )E 0G r T Fii -1. 1.' Cj 4 000 1CL 21c")O 15"57 PERMIT # NLk=ELIVER/P-U Date/By HAZ CLASS 033099ek I _ 01:F ftCOPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO - Q R�7)p 1" qn f MAIL ADDRESS CITY ZIP PHONE IITECTOR U SIGN R MAIL ADDRESS CIIY 61ZIP PHONE 'r 1105'. %' Q, &Z33 ' c 3 6-y3,6-/od 0 N,' GENERAL CON I RAC TOR MAIL ADDRESS CITY _ ZIP PI(ONE LICENSE I MLLI NANILAL CONTRACTOR MAIL ADDRESS CITY ZIP PFIONE LICENSE Ii PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS Of WORK NI W ❑ AUDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI LION ❑ BUILDING RELOCATION VALUAT ION OF WORK s resso Li UESCRIB WORK �. ;4 no,, ' A r r'rl ru 0 w z J J J a w CL �l U PROPU U USL OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT IRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATU ' CONTRACTOR OR A' HORIZED AGENT GATE LLUAL IASCRIPiION01 PROPERTY SFIOWN BELOW OR A[TALII FOUR COPIFSI LOI__BLOCK OF TAX 1 NUMBER FROM PROPERTY TAX STATEMENT �r �7 G/y b�O �� (1 IOB AUURLSS (OFFICE USE ONLY) P LU MBI N CI v— - - WECIIANICAL NO. TYPE OP FIXTURE FEE i s FIXTURES NO. TYPE OP EQUIPMENT FBB x°s FIXTURES WATER CLOSU1 ILET IR COND. UNITS -_H.P. EA. tip. lit•• SATIITUTI _ Q'RICIERATION UNITS - II.P. BA d . Ilt•• VATORY ffMlI BASIN OILERS - ILP. ILA. ti . lit•• IIOWER AS FIRED A.C. UNITS-TONNAOBEA. d .Ilt•• ITCIION SINK & DISPOSAL TORCED AIR SYSTEMS - B.T.V. MEA ISHWASHER ALL l IEATERS - D.T.U. M JLUNDRY TRAY JNITIIEATERS - D.T.U. M I.OTIIES WASIIER _ VAPORATIVBCOOLERS ATER HEATER LOTTI13S DRYERS RINAL oFENTILATION PAN )KINKING FOUNTAIN kANGBIIOOD COMMERCIAL FLOOR DRAIN _ IR IIANDLING UNIT - CPM VACUUM BREAKERS TOVE OOP DRAINS - RAINLEADERS ETAL FIREPL ACE R CIIIMNLTY INK . ERVICE - EAR. ETC. A- R IIEATER AS PIPING *(ue to S - $3.00. ■ddnl. 3.7S • ul meet list must Im provided SUS TOTAL SUB TOTAL. - PL'RMrr PERMIT TOTAL PEE TOTAL PEE SIDI. YARD SL I11ACK S TRLI.I SL I BACK REAR YARD SE TBACK PLAN CIILCK NUMBER PLAN FEE CHECK FEE RECEIPT NO. - USI/ON[ LOI ARIA VACANT SITE ❑ YES ❑ NO FEES VALUATION FEE PLAN CHECKING NG IYPL OF CONSI OCCUPANCY GROUP NO. OFDWELLING UNITS BU'LDING 1 SIAL OI BLUC.. NO, Of STOWLS MAX.000. LOAD PLUMBING f IRE SPRINKLERS REQUIRED YES ❑ NO COMMENTS "1- - - MECHANICAL STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC. 303(a) WATER/SEWER FEES TOTAL nr_t-0-IVCU PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT 6 RECEIPT PAID CRN - BY - cc ASSESSOR. APPLICANT, TREASURER. BLDG DEPT. I BUILDING OFFICIAL DATE RECORDS COPY City of Arlington o '341N�' Katherine L. Cherrier Bank of America 501 N. Olympic Ave. Arlington, WA 98223 RE: Assignment of Savings Account/Certificate of Deposit Acct. # 13591508 — Your Daily Grind Espresso Dear Katherine: This letter is to authorize the release of the above noted assignment of funds. All landscaping as required for this project has been installed, inspected and the City Engineer Paul Richart has authorized release. If you should have any questions, please contact me at 360.402.3503. Respectfully, Cristy . rubaker Public orks Coordinator Cc: File Frank DeGraff 238 North Olympic Ave. 01� �o OX' 801 Arlington, WA 98223 NOV-17-2000 FRI 03:59 PM BAILEY,DUSK[N & PEIFFLE FAX NO, 360 435 6060 ASSIGNMFNT Ole SAVINGS ACCOUNT/CERTIFICATE OF DEPOSIT P. 02 *Ot, �Fn ,q,�L,; 1 The undersi(med has the following per it anolication or development approval pending with the City of Arlington, Washington: The terms of the City's approval of said Project a , iticorporatc herein by this reference. 2. This assignment atislies the requirement of bonding for the following requirements of the City of Arlington: 3. The undersigned does hereby assigtransfer, and set over to the City of Arlington all };ght, itic and interest to the su of S� , which is presently held in t dank, , ,17� � branch, Account 4. if the undersigned fat fully performs all oFthe above obligations described in paragraph (2), above, and has demonstrated to the satisfaction of the City of Arlington that any and all laborers, mechanics, materialmen, subcontractors assisting in the completion of the requirements above described have been paid, then this agreement shall be null and void and the City of Arlington shall release the aforementioned funds. 5. TFthe undersigned, upon written demand by the City of Arlington and at least 14 days' prior notice, fails to complete the requirements as set forth in paragraph (2), then the City of Arlington may, in its discretion, withdraw said funds described in paragraph (2) for the purpose of completing the work above described, Any such action by the City of Arlington shall not release the undersigned from liability, and the undersigned agrees that it shall remain responsible for all costs incurred by the City of Arlington in completing; the tasks described in paragraph (2), above, less any sums withdrawn pursuant to this paragraph. G. This agreement shall be binding on the undersigned and on their successors and assigns. DATED: s 1�Ilaturc ACCEPTANCE The undersigned hereby accepts the foregoing Assignment of Savings Account/Certificate of Deposit, Account or Certificate No. 11.r. in the amount of Sp+� �, and agree to abide by its terms. DATE: `/:V'Q6 C Bank Branch -TQSNOHOMISrI HEALTH DISTRICT November 15, 2000 Chanda Dorsey 24923 Jim Creek Road Arlington, WA 98223 ENVIRG-rv,AENTAL HEALTH DIVISION 3020 Rucker Avenue, Suite 104 Everett, WA 98201-3900 425.339.5250 FAX:425.339.5254 Healthy Lifestyles, Healthy Communities RECEIVED NOV 17 2000 CITY OF ARLINGTON Subject: Proposed, Your Daily Grind Espresso, 624 North Broadway Street, Arlington Dear Ms. Dorsey: Your plans have been reviewed with the Rules and Regulations of the State Board of Health, and with the policies of the Snohomish Health District. With the addition of the following, the plans are approved. 1. A copy of the proposed menu must be submitted. 1. The food stand sink must be a counter top unit. Under counter rollout handsinks are not acceptable. Handwash sinks must be provided with hot and cold water. A holding tank system for fresh water and waste water for the hand sink is acceptable. Waste water tanks must be 15 percent larger than the fresh water tank. If hard plumbed water is supplied to the food stand then a hard plumbed connection to sewer must also be provided. 2. All light fixtures in food preparation and storage areas must be provided with covers or shatter proof bulbs. A preoperational 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 $130.00 reinspection fee. Please contact the Food Program office a minimum of one week in advance to schedule an appointment. This will ensure compliance with the Rules and Regulations of the State Board of Health for Food Service Sanitation. If there are any significant changes or additions to your layout or equipment, the Snohomish Health District must be notified. Please contact me if you have any questions. My office number is 425.339.5250. S ncere� � Rob rt A. oppa, R.fi: Environmental Heath Specialist RH/ek cc: City of Arlington Building Department ';i�.1NGp j �Sir�xt:. CITY OF A RU I NGTON CONSTRUCTION 1F3-aRM I T PERMIT No- o O O —43 22 Owner: DEGRAFF, FRANK 24923 JIM CK RD ARLINGTON 98223 Value of Work: $10,000.00 Tax ID: 46180070010000 Phone: 206-890-5192 Describe Work: ESSPRESSO STAND Proposed Use: ESSPRESSO STAND Legal Description: Job Address: 624 NORTH BRODWAY Contractor's Naee Type Address License# FRANK DEGRAFF OWN 24923 JIM CREEK ROAD TOTALS Fee Pereit Fee $250.00 TOTALFEE ................. $250.00 PAYMENTS.................. $350.00 TOTAL DUE.................-S100.00 DATE �/, 2 00 RECEIPT # /6-Fd3 CITY OF ARLINGTON 238 N. Olympic Ave. Arlington, WA 98223 (360) 435-5785 SISNATURE: I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED.THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS LAWS AND ORDINANCES GOVERNI THIS TYPE OF WORK WILL BE 0MP ED TH WHETHER SPEC4ii ED UILD;4G OFFICIAL RECEIVED ****THREE HUNDRED FIFTIYbOLLARS"& 00 CENTS RECEIPT No. RECEIVED FROM DATE REC. NO. AMOUNT YOUR DAILY GRIND ESPRESSO 1i/07/00 15803 FRANK DEGRAFF 350.00 CHECK MISCELLANEOUS RECEIPT COUNTER 9.00.01.00 Standards Sta.w inning 5.89.02 Land Use Permit Processing 15803 REF. NO. 1711 C ITV OF ARL I NOYON COMO-r RUCTION RE RM I T RE RM I T NO-2 00-43a2 Owner: DEGRAFF, FRANK 24923 JIM CK RD ARLINGTON 98223 Value of Work: $10,000.00 Tax ID: 46180070010000 Phone: 206-890-5192 Describe Work: ESSPRESSO STAND Proposed Use: ESSPRESSO STAND Legal Description: Job Address: 624 NORTH BROD'WAY Contractor*s Name Type Address License# FRANK DEGRAFF OWN 24923 JIM CREEK ROAD TOTALS Fee Permit Fee $250.00 TOTAL FEE ................. $259=00 PAYMENTS .................. $358.00 TOTAL Imo ................. DATE RECEIPT # /StTo3 SIGNATURE I HEREBY CRTIFY THAT I HAV REA D AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS LAWS AND ORDINANCES GOVERN, THIS TYPE OF WORK WILL BE OVIP ED ' TH WHETHER SPEC4FA ED ILDr OFFICIAL CITY OF ARLINGTON 238 N. Olympic Ave. Arlington, WA 98223 ■� - (360) 435-5785 RECEIPT No. 15803 r - RECEIVED � *'***THREE HUNDRED F IFTY DOLLARS° `& 00 CENTS M RECEIVED FROM 1 U. YOUR DAILY GRIND ESPRESSO FRANK DATE REC. NO. AMOUNT REF. NO. 11/07/00 15803 m DEGRAFF 350.00 CHECK 1711 ` In a MISCELLANEOUS RECEIPT N COUNTER I 002.389.00.01.00 Standards uo.uu Planning 001.345.89.02 Land Use Permit Processing 001.389.00.04 Direct Deposit 001.341.50.01 Maps & Publications Building 001.322.10.00 Building 3&Ct 001.345.83.00 Plan Check Fee 001.386.00.01 St. Bldg. Code Fee Miscellaneous 001.341.60.00 Copy Fees 107.002.344.85.00 Trip Generation Mitigation 107.003.345.85.00 Parks Mitigation 107.003.345.85.02 County Parks Mitigation 107.006.345.85.00 Arlington School Mitigation 107.006.345.85.00.01 Lakewood School Mitigation 103.343.83.00.00 Surface Water System Dev. fee Total Receipts $ C:1...%sheff kpsulrs bar codes 8= 0 n 71 t� 0 I I I CA t v l G I ss I I mouxa�{ G�ravCtR act ,� ccT 5�ru�5 oZc�. �--• $Xly f 3oal, z r I Scc. +Nurrc i I I 1! 'ZI l,-r trIc 10'`-XIDI, h �alC. Cell If bs ' ;qQ 4_t 0 Nib pv i Xtl E"4y ChCLVV deLl D a I"-; V);/ P ' ('0 F I V E D N 0 3 7W Q I-." X L4 C%,Ck C"Ir CL Ll ILL LL 0 ! � f ti r �; OFP.. �_ �� _a E iE Ea 2000 x re: ry _%ems__ _ 74:�2 lo� I —fl -7Z-O -rA -? &6 - q 5 S- - &ZOO Q-- Me RECEIVED 2000- y j SNOHOMISH ENVIRONMENTAL HEALTH DIVISION HEALTH Food Program �= �3{}20 'Rucker Avenue, Suits 704 DISTRICT Everett, WA 98201-3900 425.339.5250 Fax:425.339.5254 Healthy Lifestyles, Heald }i communities APPLICATION FOR FOOD STAND CONCESSION, MOBILE. FOOD VEHICLE, LIMITED GROCERY OR INSPECTION WITHOUT PLAN REVIEW PROPOSED ESTABLISHMENT: r (ntime) Food Stand Concession _ 71 Mobile Food Vehicle (locatio dd ss) ❑ Limited Grocery ❑ Reopening Existing (city) Food Service Establishment �1 W (Z1p) OWNER OF ESTABLISHMENT:re- rp� /�f Ott ✓ (Warn f telephone) (address (state) (zip) CONTACT PERSON: J'6e --%D-3— 72�r-7 (for plan review purposes) (name) �. (telephone) (addres ?Gilt`' (city) (state) (zip) —4-� COMMISSARY NAME 1 LOCATI `. /7* TdQeil&e%V, (Name, street address, and city) r , COMMISSARY Public COMMISSARY Sewer WATER SUPPLY: (nafrie of system) SEWAGE DISPC]S .. ❑ Private Well gn DESCRIBE ESTABLISHMENT OPERATIONS: (include hours of operation) c "&- � 2/"z "llaw— Z'e�- Inspection. is basedupon requirements of WAC 246-215, Rules & FOR OFFICE USE ONLY Regulations of the State Board of Health for Food Service Sanitation. PI i i--.4 .195 , 0o Other agency approvals requisite to your operation may include County TOTAL .1.97,.06 or City Planning, Building, Plumbing and Fire Departments, Water and :i t off, 60 Sewer Utilities. C. HH14G;F 0.00 SEE C N'T' FEE SCHEDULE TTEM I.'1.-ii,7-('r + �44i�iii11;;f ;'•1 �'� :! � � �- �_ f SIGNATURE OF APPLICANT DATE SNOHOMISIf Environmental Health Division HEALTH Food Program 3020 Rucker Avenue, Suite 104 DISTRICT -" Everett, WA 98201-3900 Phone:425-339-5250 Fax:425-339-5254 APPLICATION FOR F+C)� Ib- SERVICE FOOD TAND CONCESSION/ MOBILE FOOD VEHICLtiE/ COMMISSARY PERMIT s Establishment Name Telephone # Manager Establishment Street A s Owner Home Phone mil/" rr -5 QA, - bp, rn, Fssttabllis ent City J 21P Establishment Operation Days & Ho (Months if seasonal) Mailing Address (If different from tate Change in ownership? Please check the box and fill in the necessary information on the back of this application. Permits are NOT transferable. Permits valid through December 31. Permits issued on or after September 1' will be charged one-half total annual per 'fi fee. x ,2va� Signature Date FOOD STAND CONCESSION/ MOBILE FOOD VEHICLE/ COMMISSARY CATEGORIES: Check which applies, complete the application, and submit the original, color -coded application with correct fee per the fee schedule. Also include any other required information such as commissary and itinerary letters. COMMISSARY N O V ( 20OG FOOD STAND CONCESSIONS) ,,►' u `= Commissary: r, amcm a comaussaay letter MOBILE FOOD VEHICLES) Commissary: u £co+'n*'n4«Yy/itlnerdry letter License number(s): TOTAL AMOUNT ENCLOSED FOR HEALTH DISTRICT USE TiITHi 1Fi O - 0 0 C.4TFi4ri CA W C )E 0G r T Fii -1. 1.' Cj 4 000 1CL 21c")O 15"57 PERMIT # NLk=ELIVER/P-U Date/By HAZ CLASS 033099ek I _ 01:F ftCOPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO - Q R�7)p 1" qn f MAIL ADDRESS CITY ZIP PHONE IITECTOR U SIGN R MAIL ADDRESS CIIY 61ZIP PHONE 'r 1105'. %' Q, &Z33 ' c 3 6-y3,6-/od 0 N,' GENERAL CON I RAC TOR MAIL ADDRESS CITY _ ZIP PI(ONE LICENSE I MLLI NANILAL CONTRACTOR MAIL ADDRESS CITY ZIP PFIONE LICENSE Ii PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS Of WORK NI W ❑ AUDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI LION ❑ BUILDING RELOCATION VALUAT ION OF WORK s resso Li UESCRIB WORK �. ;4 no,, ' A r r'rl ru 0 w z J J J a w CL �l U PROPU U USL OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT IRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATU ' CONTRACTOR OR A' HORIZED AGENT GATE LLUAL IASCRIPiION01 PROPERTY SFIOWN BELOW OR A[TALII FOUR COPIFSI LOI__BLOCK OF TAX 1 NUMBER FROM PROPERTY TAX STATEMENT �r �7 G/y b�O �� (1 IOB AUURLSS (OFFICE USE ONLY) P LU MBI N CI v— - - WECIIANICAL NO. TYPE OP FIXTURE FEE i s FIXTURES NO. TYPE OP EQUIPMENT FBB x°s FIXTURES WATER CLOSU1 ILET IR COND. UNITS -_H.P. EA. tip. lit•• SATIITUTI _ Q'RICIERATION UNITS - II.P. BA d . Ilt•• VATORY ffMlI BASIN OILERS - ILP. ILA. ti . lit•• IIOWER AS FIRED A.C. UNITS-TONNAOBEA. d .Ilt•• ITCIION SINK & DISPOSAL TORCED AIR SYSTEMS - B.T.V. MEA ISHWASHER ALL l IEATERS - D.T.U. M JLUNDRY TRAY JNITIIEATERS - D.T.U. M I.OTIIES WASIIER _ VAPORATIVBCOOLERS ATER HEATER LOTTI13S DRYERS RINAL oFENTILATION PAN )KINKING FOUNTAIN kANGBIIOOD COMMERCIAL FLOOR DRAIN _ IR IIANDLING UNIT - CPM VACUUM BREAKERS TOVE OOP DRAINS - RAINLEADERS ETAL FIREPL ACE R CIIIMNLTY INK . ERVICE - EAR. ETC. A- R IIEATER AS PIPING *(ue to S - $3.00. ■ddnl. 3.7S • ul meet list must Im provided SUS TOTAL SUB TOTAL. - PL'RMrr PERMIT TOTAL PEE TOTAL PEE SIDI. YARD SL I11ACK S TRLI.I SL I BACK REAR YARD SE TBACK PLAN CIILCK NUMBER PLAN FEE CHECK FEE RECEIPT NO. - USI/ON[ LOI ARIA VACANT SITE ❑ YES ❑ NO FEES VALUATION FEE PLAN CHECKING NG IYPL OF CONSI OCCUPANCY GROUP NO. OFDWELLING UNITS BU'LDING 1 SIAL OI BLUC.. NO, Of STOWLS MAX.000. LOAD PLUMBING f IRE SPRINKLERS REQUIRED YES ❑ NO COMMENTS "1- - - MECHANICAL STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC. 303(a) WATER/SEWER FEES TOTAL nr_t-0-IVCU PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT 6 RECEIPT PAID CRN - BY - cc ASSESSOR. APPLICANT, TREASURER. BLDG DEPT. I BUILDING OFFICIAL DATE RECORDS COPY