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HomeMy WebLinkAboutPermit D04-319 - SOUTHCENTER MALL - PURPLE BUTTERFLY ESPRESSO AND DELIGHTS - KIOSKPURPLE BUTTERFLY ESPRESSO & DELIGHTS 406 SOUTHCENTER MALL H' W re Wes• J U: UO N W =, J 1.- U) w0 LL < =a z� �0 zI- uj U to • H w w: U H — LL .z w O F' z City of Tukwila 1 Department of Comn :unity Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: cOukwila.wa.its DEVELOPMENT PERMIT Parcel No.: 5379200330 Address: 406 SOUTHCENTER MALL TUKW Suite No: Tenant: Name: PURPLE BUTTERFLY ESPRESSO & DELIGHTS Address: 406 SOUTHCENTER MALL, TUKWILA WA Owner: Name: ]G SOUTHCENTER LTD Address: 25425 CENTER RIDGE RD, CLEVELAND OH Contact Person: Name: BARBARA /DAWN RHODES Address: 9917 RAINIER AV S, SEATTLE WA Contractor: Name: ARCHITECTURAL INT /CNST SRV INC Address: PO BOX 73397, PUYALLUP WA Contractor License No: ARCHIIC043C1 Permit Number: Issue Date: Permit Expires On: Phone: Steven M. Mullet, Mayor Steve Lancaster, Director D04 -319 09/22/2004 03/21/2005 Phone: 425 922 -9433 Phone: 253 - 848 -5948 Expiration Date: 10 /09/2005 DESCRIPTION OF WORK: INSTALLING 200 SQ FT ESPRESSO /FOOD SERVICE KIOSK. Value of Construction: $6,000.00 Fees Collected: $260.48 Type of Fire Protection: SPRINKLERS /AFA International Building Code Edition: 2003 Type of Construction: VB Occupancy per IBC: 0019 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Size (Inches): 0 Flood Control Zone: N Hauling: N Start Time: End Time: Land Altering: N Volumes: Cut 0 c.y. Fill 0 c.y. Landscape Irrigation: N Moving Oversize Load: N Start Time: End Time: Sanitary Side Sewer: N Sewer Main Extension: N Private: Public: Storm Drainage: N Street Use: N Profit: N Non - Profit: N Water Main Extension: N Private: Public: Water Meter: N doc: IBC- Permit D04 -319 Printed: 09 -22 -2004 Z H w Q: 2 D UO (1)o J = I` . CO U. w �Q rn � = Cy �w Z �O Z i-- w U (3 co wW XU U. O -.Z W 0�. z 190 M•f 8 City of Tukwila Steven M. Mullet, Mayor Departmernt of Commuttity Developuteitt 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tuktivilamams Permit Number: Issue Date: Permit Expires On: Steve Lancaster, Director D04 -319 09/22/2004 03/21/2005 Permit Center Authorized Signature: Date: 9 I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of-this permit does not regulating cqKstrucbjqp or the perfidr Signature: Print Name. ne to give authority to violate or cancel the provisions of any other state or local laws of work. I am authorized to sign and obtain this development permit. Date: ZL - 17'vS- CL'L.) This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. doc: IBC - Permit D04 -319 Printed: 09 -22 -2004 Z ;= Z W JU UO N O w =` NU W O. U- Q � = ,- W Z w� �5 U� O c. =W LL O w Z O Z y City of T ukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Z Parcel No.: 5379200330 Permit Number D04 -319 �z w Address: 406 SOUTHCENTER MALL TUIKW Status: ISSUED 2 Suite No: Applied Date: 08/30/2004 v Tenant: PURPLE BUTTERFLY ESPRESSO & DELIGHTS Issue Date: 09/22/2004 v o C0 UJ J = 1: ** *BUILDING DEPARTMENT CONDITIONS * ** U. W O 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. Q co w 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to start of any construction. These documents shall be maintained and made available until final inspection approval is Z granted. O 4: All construction shall be done in conformance with the approved plans and the requirements of the International Z H Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. v o ON 5: All food preparation establishments must have Seattle /King County Department of Public Health sign -off prior to opening a �_ = or doing any food processing. Arrangements for final Health Department inspection shall be made by calling Seattle /King v County Department of Public Health, (206/296- 4928), at least three working days prior to desired inspection date. On U 0 — work requiring Health Department approval, it is the contractor's responsibility to have a set of plans approved by the Z agency on the job site. v cn 6: There shall be no occupancy of a building until final inspection has been completed and approved by Tukwila building F- _ z ~. i No exception. 7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum distance of 4- inches shall be maintained above the controls with the strapping. 8: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Department of Public Health - Seattle and King County (206/296- 4932). 9: All electrical work shall be inspected and approved under a separate permit issued by the Washington State Department of Labor and Industries (206/248- 6630). 10: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. 11: ** *FIRE DEPARTMENT CONDITIONS * ** 12: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable with the following concerns: 13: The total number of fire extinguishers required for a light hazard occupancy with Class A fire hazards is calculated at one extinguisher for each 3,000 sq. ft. of area. The extinguisher(s) should be of the "all purpose" (2A, 10 B:C) dry doc: Conditions D04 -319 Printed: 09 -22 -2004 J�vV ►L& win —� �-- I � \� City of Tukwila ro Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 chemical type. The travel distance to any extinguisher must be 75' or less. (IFC 906.3) (NFPA 10, 3 -2.1) 14: Portable fire extinguishers, not housed in cabinets, shall be installed on the hangers or brackets supplied. Hangers or Z brackets shall be securely anchored to the mounting surface in accordance with the manufacturer's installation W instructions. Portable fire extinguishers having a gross weight not exceeding 40 pounds (18 kg) shall be installed so 5 that its top is not more than 5 feet (1524 mm) above the floor. Hand -held portable fire extinguishers having a gross _3 0 weight exceeding 40 pounds (18 kg) shall be installed so that its top is not more than 3.5 feet (1067 mm) above the C o o floor. The clearance between the floor and the bottom of the installed hand -held extinguishers shall not be less than 4 W w � inches (102 mm). (IFC 906.7 and IFC 906.9) H WLL W 0 15: Fire extinguishers shall not be obstructed or obscured from view. In rooms or areas in which visual obstruction cannot be completely avoided, means shall be provided to indicate the locations of the extinguishers. (IFC 906.6) J 16: Extinguishers shall be located in conspicuous locations where they will be readily accessible and immediately available LLQ N a for use. These locations shall be along normal paths of travel, unless the fire code official determines that the w hazard posed indicates the need for placement away from normal paths of travel. (IFC 906.5) z � 17: ** *MEANS OF EGRESS * ** - IFC Chapter 10 f- 0 w w 18: No point in a building may exceed the maximum exit access travel distance listed in Chapter 10, section 1015, Table v co N 1015.1 of the International Fire Code and International Building Code. 0 �- 19: Egress doors shall be readily openable from the egress side without the use of a key or special knowledge or effort. W -- H v ( 1008.1.8.3 subsection 2.2) u- 0 _ 20: Dead bolts are not allowed on auxiliary exit doors unless the dead bolt is automatically retracted when the door handle v co is engaged from inside the tenant space. (IFC Chapter 10) 0 H 21: Exit hardware and marking shall meet the requirements of the International Fire Code. (IFC Chapter 10) Z 22: Gates serving the means of egress system shall comply with the requirements of the International Fire Code. Gates used as a component in a means of egress shall conform to the applicable requirements for doors. (IFC 1008.2) 23: ** *SPRINKLER SYSTEMS * ** - IFC Chapter 9 - NFPA 13 and 25 24: Maintain sprinkler coverage per N.F.P.A. 13. Addition /relocation of walls, closets or partitions may require relocating and /or adding sprinkler heads. (IFC 901.4) 25: All new srpinkler sysetms and all modifications to existing sprinkler systems shall have fire department review and approval of drawings prior to installation or modification. New sprinkler systems and all modifications to sprinkler systems involving more than 50 heads shall have the written approval of the W.S.R.B., Factory Mutual, Industrial Risk Insurers Kemper or any other representative designated and /or recognized by the City of Tukwila, prior to submittal to the Tukwila Fire Prevention Bureau. No sprinkler work shall commence without approved drawings. (City Ordinance #2050) 26: All sprinkler system plans, calculations and the contractors Materials and Test Certificates submitted to the Tukwila Fire Prevention Bureau must be stamped with the appropriate level of competency seal. (WAC 212 -80) 27: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2050 and #2051) 28: ** *ELECTRICAL * ** - IFC - NFPA 70 - NEC 29: All electrical work and equipment shall conform strictly to the standards of the National Electrical Code. (NFPA 70) doc: Conditions D04 -319 Printed: 09 -22 -2004 't, .�+. ., J�.:. . tNl;:.: ia.,. a. v:.. w: iT .:�v.;6:y,:la:i «:U:uwrn76,c:M Y+c:.�'.i:i:•.dzai:na �:vx >:a .�+ -uMw aa:i . (,iwlFvwuuu,4v ?:aawaYr "'13ii ' 3.' i1N41W�+ G{ fumi :ir.;�r1:�ir��:3i:�u�ii... Citv of Tukwila 1908 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 30: ** *BUILDING CONSTRUCTION * ** - IFC - IBC 31: When walls and ceilings are required to be of fire resistive or noncombustible construction, interior finish materials shall meet the requirements of International Building Code 803. 32: Accumulation of combustible waste material is prohibited during the demolition phase of this project. Remove and properly dispose of all waste material prior to the close of the working day and as often throughout the day as needed. 33: These plans were reviewed by Inspector 510. If you have any questions, please call Tukwila Fire Prevention Bureau at (206)575 -4407. * *continued on next page ** f c i doc: Conditions D04 -319 Printed: 09 -22 -2004 z iH W ' UO N� CO N U. W O J U- Q = �W z� HO z i - LLI U� O -; ' Cl �- W Ux �U F-- LL O: W U C& ~O H, Z g rihf o Tukwila k f909 � Y Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws regulating consqucfiQn or the performance of work. Signature: Date: 7 ' 2 j y Print Name: j r I ; doc: Conditions D04 -319 Printed: 09 -22 -2004 z H Z QQ �: JU cU 0 CO) CO) LLJ CO) U. W CY F- w Z� w Uj D `O CO 0 D I—: wW ti O. ll1 Z U= O Z Ua, w4s u� o r tsoe Name: A r14 Mailing Address: E -Mail Address: _h4 CITY OF TUKWILA t`'`* ) Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 use 1 Building Permit ivo. Mechanical Permit No. Public Works Permit No. Project No. Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. * *Please Print ** �I SITE- LOCATION L f�G '`_ Site Address: Tenant Name: P arol e Property Owners Name:& Mailing Address: 1/ 4 � 0 0 , CONTACT PERSON I X King Co Assessor's Tax No.: 5a 7 L� "0 . Suite Number: Floor: Q New Tenant: X... Yes ❑ ..No 12eo l� State r /�� `7 OlJ �S City Zip Da Telephone: — kg x1 & - A ✓ u !Id L � I City state State t Zip 1(�T� r rga Q I • (00 Fax Number: ° Qb 11,1 1 ',3 /'& GENERAL CONTRACTOR INFORMATION - (Mechanical Contractor information on back page) ARCHITECT OF RECORD — All plans must be wet stamped by Architect of Record Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: * *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance ** Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: i E -Mail Address: Fax Number: i ENGINEER OF RECORD — All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: \permits plus \icc changes \permit application (7.2004) Page t State Zip Z ~ W t Y W �U UO W� CO) LL W 2 QQ LLQ CO) D _CY �W Z F_ f-- O W H W U� CO OH W 2 H(.5 LL O . Z . W U= O~ Z BUILDING PERMIT INFORMATION - 206 - 431 -3670 Valuation of Project (contractor's bid price). $ 0 D 0 Existing Building Valuation: $ Scope of Work (please provide detailed information): A __ .-, - --G - - -- - - Will there be new rack storage? ❑ ..Yes Fl.. No If "yes ", see Handout No. - for requirements. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single - family bull 'n footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwellin , vide the following: Lot Area (sq ft): area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the i al owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? E] .... Yes ❑ ..No If "yes ", FIRE PROTECTIONIHAZARDOUS MATERIALS: .. Sprinklers Automatic Fire Alarm []..None ❑ . Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ ..Yes ❑ ..No If "yes ", attach list of materials and storage locations on a separate 8 -112 x I I paper indicating quantities and Material Safety Data Sheets. \permits plus\icc changes\permit application (7 -2004) Page 2 ZZ `~ W DC � JU 0 to 0 W = H CO LL WO �� LL Q CO CY CY �W Z F-. HO Z F— W W U� ON 0 t-- WW H� u. O 111 Z CO) H O F-- Z Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1St Floor 2 "d Floor 3 Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport - Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single - family bull 'n footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwellin , vide the following: Lot Area (sq ft): area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the i al owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? E] .... Yes ❑ ..No If "yes ", FIRE PROTECTIONIHAZARDOUS MATERIALS: .. Sprinklers Automatic Fire Alarm []..None ❑ . Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ ..Yes ❑ ..No If "yes ", attach list of materials and storage locations on a separate 8 -112 x I I paper indicating quantities and Material Safety Data Sheets. \permits plus\icc changes\permit application (7 -2004) Page 2 ZZ `~ W DC � JU 0 to 0 W = H CO LL WO �� LL Q CO CY CY �W Z F-. HO Z F— W W U� ON 0 t-- WW H� u. O 111 Z CO) H O F-- Z N MECHANICAL PERMIT INFuRMATION — 206 - 431 -3670 MECHA Company Mailing A Contact Person: E -Mail Address: Contractor Registration Number:_ * *An original or notarized copy Valuation of Project (contractor's bid price Scope of Work (please provide detailed inf City State Zip Day Telephone: Fax Number: Expiration Date: Washington State Contractor License must be presented at the time of permit issuance ** Use: Residential: New .... ❑ Commercial: New .... ❑ Fuel Type Electric ..... ❑ Gas ....❑ Replacement..... ❑ Replacement..... ❑ Other: Indicate type of mechanical work being installed and the quantity below: Unit Type: Qty Unit Type: Qty Unit Type: Boiler /Com pressor: Q Furnace <100K BTU Air Handling Unit >I0,000 Fire Damper 0 -3 HP /100,000 BTU CFM Furnace >100K BTU Eva orator Cooler Diffuser - 3- HP /500,000 BTU Floor Furnace Ventilation Fan Connected Thermostat 15 -3 IP /1,000,000 BTU to Single Duct Suspended/Wall /Floor Ventilation System Wood /Gas Stove 30 -50 HP/T, 50,000 BTU Mounted Heater Appliance Vent Hood and Duct Water Heater 50+ HP /1,750,00 TU Repair or Addition to Incinerator - Domestic Emergency Heat/Refrig/Cooling Generator System Air Handling Unit Incinerator — Comm/Ind Other Mechanical <10,000 CFM I I Equipment PERMIT APPLICATION NOTES.—. Applicable to all permits in this application Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once. I HEREBY CERTIFY THAT I HAVE READ ANDEXAM INED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE TA E OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING O R OR UT ORIZE / GEN Signature: �t I Date: v �S^ Print Name: 2 ' ?0 Day Telephone: Mailing Address: k I -Q Q City state zip Date Application Acce ted, Date Application Expires: j Staff Initials: \permits plus\icc changes \permit application (7.2004) ' ICAL CONTRACTOR INFORMATION Page 4 Z '~ w � QQ 2 W V . UO to o (D LIJ J H U) LL WO LLQ U) = �W Z = F- Z� �5 U ON a F- WW H u O .Z U= ~O f- Z .J�'kap7�1'xY ,±:' tWH!^ v�eA: AaMlcatt' �rf! r. Nw Y, r? au2 !er!'JxrW'�x!t- r;' ".rf , iu�iK�y �:F??.ltrt', TR qq i!s.irrm::ert++:a..ws ��iw .�ce�;fs'rt��.:; -3=: � 1 .� City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 RECEIPT Parcel No.: 5379200330 Address: 406 SOUTHCENTER MALL TUKW Suite No: Applicant: PURPLE BUTTERFLY ESPRESSO & DELIGHTS Receipt No.: R04 -01157 Initials: SKS User ID: 1165 Payee: DAWN R. RHODES Permit Number D04 -319 Status: PENDING Applied Date: 08/30/2004 Issue Date: Payment Amount: 260.48 Payment Date: 08/30/200410:53 AM Balance: $0.00 TRANSACTION LIST: Type Method Description Amount ---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - -- Payment Check 3434 260.48 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - NONRES 000/322.100 155.14 PLAN CHECK - NONRES 000/345.830 100.84 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 260.48 Z z �_- Z � JU UO No w= J �- TLL W� u_ N �W Z f- I— O Z F- LLI5 U� O Cj). �H W W. UO .. Z. W O Z l RE RECORD C Retain a copy with permit INSPECTION NO. PE MIT CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Proje ea Type of Inspection: Addre y Date Called. 3 Instructions: Date Wanted:i (� a.m. Requester: Phone No: Receipt No.: Date: Z H W �QQ � Wes• UO Cl C0 III Cl) U . WO U. j N X Z H H O Z I-- O N oI- WW 2 lil Z CO P O Z �"'—' paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit Lzw INSPECTION NO. P V O. CITY OF TUKWILA BUILDING DIVISION K 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ()06)431 -3670 Pro' t: Type of inc art n* 1 7V *W4 Ada res,,s - Date Called: Special Instructions: Mate Wanted _1,3 a.m. Requester: Phone No: F Approved per applicable codes. FICorrections required prior to approval. paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: Z D 00 CO 0 Wx T U-- W O. Ei LL. c o CY W 3: z F R Uj 5 D 0 0 cf) 0— C ) 1-- W IL —ol z CO) F- 0 ,z "' r �r �' :,.'; C'' �.R�rt1 i.',��.��n 'F�.T�St7o�rt- !�..r�n�- -n.- -, .l� *"•_^.'^.' ^`t^,^�,`;C_^!' -1•'y, , . ILA 1 1 1 1 1 1 TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Approved without correction notice Approved with correction notice issued Thomas P. Keefe, Fire Chief Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: city of Tukwila Steven M. Mullet, Mayor Fire Department uthorizecr Signature FINALAPP.FRM Rev. 2/19/98 / / Date T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206 -575 -4404 • Fax. 206 -575 -4439 i f' z ~ w JD 0 CO 0 J = H S2 LL WO a � a LLQ N D = �W Z F_ O z I_ W 25 D O co, o�_ WW 2 5 F_ �O z W U= O z Public Health Seattle & King County HEALTHY PEOPLE. HEALTHY COMMUNITIES. Alonzo L. Plough, Ph.D., MPH, Director and Health officer July 20, 2004 Dawn R. Rhodes 9917 Rainier Ave S. Seattle, WA 98118 REVIEWED OR CODE COM IANCE APP""R SEP 15 2004 City Of TUWla BUILDIN DIVISION RE: Purple Butterfly Espresso & Deliat - 406 Southcenter Blvd Seattle, WA 98188 Dear Ms. Rhodes: We have approved the plans for your food service establishment, 6 T nF TI A AUG 3.0-2004 PERMIT CENTER Your establishment has been assigned the following business identification number (SR#1082641). Please use this SR# in all future contact us. Before you open for business, you must complete the enclosed application for a permit and return with the correct fee of ($486.00) for a (6315) permit. If you open before you obtain your permit, your permit fee will be double. Before you open need to schedule a pre - operational inspection by the Health Department. Although your application for a food service establishment permit from Public Health Seattle and King. County will be approved during this inspection, you may need to obtain additional permits or approvals from other agencies. It is the responsibility of the food service establishment operator /owner to obtain all necessary permits and approvals. Operating the establishment without these required permits or approvals may subject you to legal action by the appropriate agencies. If you open without health inspection, you may be closed. Once your plumbing permit has been finalized, contact me at (206) 205 -1903 to schedule the pre - operational inspection: Failed pre - operational inspections will require a $100.00 fee for a repeat inspection. Be sure all ' other business inspections are done (plumbing, building, etc.) before you call for your Health Department inspection. Z �Z �W �QQ � JU U w W CO LL WO LL. N �. = W Z f- F- O Z ~' � o' U N 0 I— W u. O w Z U= O~ Z Should you have anv auestions or need additional information. please wive me a call. lai i � d P w w h � 0 � Z W � JU UO N J = H N U- WO J LL Q N 2 �W Z H I- O Z I- W W U� ON 1H WW H C.) O .Z CO O Z A 0- VWJWW.aMCE' j *[P&RLffjj0jc*M Model #-. 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N THIS NOTICE IT IS DUE TO THE QUALITY OF TH "d .SZ' b L PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D04 -319 DATE: 08 -30 -04 PROJECT NAME: PURPLE BUTTERFLY ESPRESSO & DELIGHTS SITE ADDRESS: 406 SOUTHCENTER MALL X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after /.before permit is issued DEP ARTMENTS: Buil "g'Division Public W rks Fire Prevention Structural ❑ DETERMINATIO OF COMPL (Tues., Thurs.) Complete Incomplete ❑ Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: �4C 0 � Planning Division Permit Coordinator DUE DATE: 08 -31 -04 Not Applicable ❑ TUES /THURS ;'Structural TING: Please Route Review Required REVIEWER'S INITIALS: APPROVALS OR CORRECTIONS Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: PERMIT COORD COPY Documents /routing sllp.doc 2 -28.02 ❑ No further Review Required ❑ DATE: DUE DATE: 09 -28 -04 Not Approved (attach comments) ❑ z i� w D. JU UO N W= J � NU. W r 0 O -j wj Cn d = W z F- w 25 0 :3 C3 ON D f- WW LL O .z W U= 0�. z Non- Residential O Department of O Natural Resources and Parks Sewer Use Certification King County (To be completed for all new sewer connections, reconnections or change of use of existing connections. This form does not apply to repairs or replacements of existing sewer connections within five years of disconnect,) Pursuant to King County Code 28.84, all sewer customers who establish a new sewer customers. The charge is collected semi - annually. All future new service which uses metropolitan sewage facilities shall be subject to a billings can be prepaid at a discounted amount. capacity charge. The amount of the charge is established annually by the King County Council at a rate per month per residential customer or Questions regarding the capacity charge or this form should be referred to residential customer equivalent for a period of fifteen years. The purpose of King County's Wastewater Treatment Division at (206) 684 -1740. the charge is to recover costs of providing sewage treatment capacity for 9 ,[� q (Please print or type) )_ n ,,I j � ^ 4 , f J� property Tax ID # � / � 7 Owner's Name 1 V (y . 1 ...J . I ' (List, First, Middle Initial) Party to be Billed (if different from owner) Subdivision Name Subdiv. # Building Name (if applicable) Property Street Address Lot # Block # City or Sewer District Date of Connection City, State, ZIP hh �� / � Side Sewer Permit # Owner's Phone Number ) .[.c' 6 jr �� 9) 3 Property Contact Phone # Owner ailing fess (if differen abo e) 1 11 7` rI II Demolition of pre- existing building? El Yes O No Type of building demolished Sewer disconnect date A. Fixture Units Fixture Units x Number of Fixtures = Total Fixture Units Kind of Fixture Fixture Units No. of Fixtures Total Fixture Units Public I Private Public Private Bathtub and Shower 4 4 Shower, per head 2 2 Dishwasher 2 2 Drinking fountain (each head) 1 .5 Hose bibb (interior) 2.5 2.5 Clotheswasher or laundry tub 4 2 Sink, bar or lavatory 2 1 Sink, Clinic flushing 8 8 Sink, kitchen 3 2 Sink, other (service) h A h i gJ4.4h 3 1.5 Sink, wash fountain, circle spray 4 3 Urinal, flush valve, 1 GPF 5 2 Urinal, flush valve, >1 GPF 6 2 Water closet, tank or valve, 1.6 GPF 6 3 Water closet, tank or valve, >1.6 GPF 8 4 Total Fixture Units 2- Residential Customer Equivalent (RCE) 20 fixture units equal 1.0 RCE Total No. of Fixture Units = RCE 20 B. Other Wastewater Flow (in addition to Fixture Units identified in Section A) Type of Facility /Process: Estimated Wastewater Discharge: Gallons /days Residential Customer Equivalents (RCE): 187 gallons per day equals 1.0 RCE Total Discharge (gal /day _ RCE 187 C. Total Residential Customer Equivalents: (add A & B) A B (" y nF TiJKwII a A UG 3 p 2004 RCE PERMITC I certify that the information given is correct. I understand that the capacity charge levied will be based on this information and any deviation will require resubmission of corrected data for determination of a revised capacity charge. Signature of OW �� Representative' ' .� --' C `'� G'�✓ l Print Name o4Own Representative ` E2 _�Ov T Date 0 30 -0 y ' 1058 (Rev. 1/03) White — King County Yellow — Local Sewer Agency Pink — Sewer Customer yy yyip y11�y? • ' �,�ri gFt'}y le..it' lk: i�y.c'in1�4 • ' ILw .atrrvtl M'eal..onY+4.'�iw..1N \MG i J� Z Z W 2 0 .J U UO W = H CO W WO UQ c f)� = CY �W Z H F— O Z H �5 U� ON 0H W LLO W Z U= O Z • ' - _ - NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR - THAN THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. + \.•• ,r�� I. , r j • is l ti • J •r•;.;rlr. r•r. - r .JIH�.l,rr�•tw� •.U•rw a..iM'.Si .. • ' �' : f . • ?' •, �. T • , ' , • • • • if It Ar It 4p a ip • • •• • \ • • r_ • - .. y .� ' r • "Mid ! r ' t r ti ' -N { r •. • •• O •fir 0 t EDW « ` . . • elm" .� • :• •�••rr••Ir�• 4M M •� • � MA • • • /# i •� •�0 �M tt•� �• � .wr��� M • ♦w�A A M��ti A ••r;r • •• 4 % .• •1•.�1•. 1• •. �r �.• �• • A ♦ • • • v 41 • . .. do ago .. r ., • ^ s 1p