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HomeMy WebLinkAboutZON2015-00004 fiEP cxCC(P ��w 13ON co&� DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 W '' Tel:360.379 4450 I Fax:360.379.4451 ti 4-C Web:www.co.jefferson.wa.us/communitydevelopment E-mail:dcd(),co.jefferson.wa.us 16'11rIN0.o� 1` A 1\ct fl PERMIT APPLICATION ' i � C [ D V[ 7 Steps in the Permit Process: ' I I J r -Review application checklist to ensure all information is completed prior to submitting bpplrcatiop.E B 1 2 2015 -Make sure septic has been applied for and water availability has been proven. i -Make an appointment to meet with the Permit Technician by calling 360-379-4450. �L�___ _JU -This is not a standalone application;it must be accompanied by a project specific su le t l ` ��{�y �JtEOP.MENT pp p Y P 1 p pp "�gx} 1UT�7YDE: -Fees will be collected at intake. Additional fees may apply after review and payment is requir-. •- . - .- •-.. For Departmet the Only 0-A,4 '' it ,A Btti .�Perm Related.Application#s.- . MLA# 4. Site In rmation x, Assessor Tax Parcel Number: q q- -9 0 3 (p• Site Address and/or Directions to Property: I , oZ, 444, , v4 o -i J./ A Access(name of street(s)) from which access will be gained: ' J)c /'` spy. *' Present use of property: /0 . _ 1 .A "1'�// ,r, -p"' ` 4 .., / �(' lia _ - -• . 1 Description of Work(include p posed es): 62n.lis-1-enec,( fevieco HA -1--�r eii l.e--d cl (2d,aA A Wastewater-Seu D posa , y J This property is served by Port Townsend of Port Ludlow sewer system? YES NO — _ If not served by sewer identified above, identify type of septic system below: t ,1-R+• /� gam/ /045leI -4/2Jk Type of Sewage System Serving Property: / Septic Septic Permit#: _ _ Community Septic Name of System: Case#: Are other residences connected to the septic system? Additions or repairs to sewage system: Is it a complete or partial system installation: Complete _ _ Partial _ _ Has a reserve drainfield been designated? Yes _ _ No _ _ Date of Last Operations& Maintenance check: Attach last report to application Describe or attach any drainfield easements, covenants or notices on title,which may impact the property: 4211 .2111-/ t_______41 qive /1/111 perrnf---W1)k-'i ) • Oitr- hAibitZVY1/1 1 I/00 //e- *--) /13 lie 0 ta ()' 46e-rah 614-) / LJ io4y Dr -70 AAA-(4A- Mc FEB 1 2 2 015 :7-nywonrnr)L.:( Donna Frostholm From: Donna Frostholm Sent: Thursday, March 26, 2015 1:41 PM To: Mina Kwansa Subject: FEP15-00006 El Sueno - DCD mobile food and beverage stand conditions Mina: Please attach the following DCD conditions and the attached site plan to the permit you issue for the El Sueno mobile food and beverage unit: 1. The applicant shall adhere to the submitted and approved itinerary. The applicant shall be responsible for ensuring that any and all applicable permits are obtained if the stand is moved to location other than that shown on the approved itinerary. 2. The applicant shall ensure that the mobile food unit is readily moveable, meaning that the unit can easily be moved within one hour. 3. The mobile stand shall have a certification by Washington State L&I with the insignia posted on the unit. 4. The stand shall meet all applicable setbacks. The setback from Rhody Drive is 35 feet. 5. At least two parking spaces shall be provided for each employee. 6. The applicant shall provide parking spaces for the commercial use, as shown on the approved site plan. 7. The parcel has been designated as General Crossroads under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. Mobile food and beverage stands are allowed in this zoning designation (JCC 18.15.040,Table 3-1). 8. Tie downs or wheel locks shall be used to ensure that the stand does not move while in operation. 9. Skirting, decking,or any other similar modification that limits the movability of the mobile unit is prohibited. 10. Accessory structures, such as picnic tables, seating, and storage sheds,are prohibited where the stand is in operation. Accessory storage structures shall be used only at an approved servicing area. 11. Trash receptacles shall be provided. Use of dumpsters is prohibited. 12. Food and beverage stands shall be located in the following manner: (a)the stand shall not block sidewalks, rights-of-way, emergency exits or fire lanes; (b)the stand and service area shall not encroach into vehicle travel lanes; and (3)the stand shall not be located within any required landscaping areas. 13. Mobile units may use temporary signs, such as sandwich boards or signs affixed to the mobile unit. Thanks much and let me know if you have any questions. Donna yrosthoCm Associate Planner/WetlandSpecialist Jefferson County Department of Community Development 621 Sheridan Street Port Townsenc‘ Washington 98368 360-379-4466 dfrosthorm@cojefferson.wa.us DCD is open from 9:00am—12:00pm and 1:00pm—4:30pm Monday through Thursday;DCD is closed on Friday. All emails sent to and from this address will automatically be archived by Jefferson County and emails may be subject to Public Disclosure under Chapter 42.56 RCW. 1 ' tit a, or 3 s,.. H 4 E. NHS s daRNE ,61 1...4 Fa N, M - a'I!, 11 (------------> 9,sietsa i - > till tZ p.. ` r n -c) co 0., .4—. _ ,ii , . e- . il "\ Vi CP r ' lillb 0 0 VI :..z ligle) AI tr 1 Pr. >1 1 .4, . ''.___:i i i.-7,, 11-,,,:) ' ,÷,- , ,:, -......... r I. - CI , , L, Cam_I 1 I '6;1 I 7 "rArl-Ef :sire Donna Frostholm From: Susan Porto Sent: Thursday, March 26, 2015 1:03 PM To: Donna Frostholm; Mina Kwansa Cc: Linda Atkins Subject: RE: El Sueno Mobile Food and Beverage Stand Donna, it is FEP15-00006. Also, after talking to Mina it sounds like the food permit has a limit to the number of conditions it can print on the permit. I need to talk to Linda about this limitation and get back to you. In the mean time to get this one moving out the door please e-mail the applicable conditions to Mina and she can print them and include it as a second sheet on the food permit. Work for you? S From: Donna Frostholm Sent:Thursday, March 26,2015 12:10 PM To: Mina Kwansa Cc:Susan Porto Subject: El Sueno Mobile Food and Beverage Stand Hi Mina: Just so you know, I have been coordinating with Susan so that I can add my DCD conditions directly into your EH permit. We are trying to set something up for all mobile food and beverage stands, not just El Sueno. Could you send me the EH case number for this application/permit so I can add my conditions in. Thanks, Donna Frostholm Associate Planner/WetlandSpecialist Jefferson County Department of Community Development 621 Sheridan Street Port Townsend 'Washington 98368 36o-379-4466 dfrosthorm@cojefferson.wa.us DCD is open from 9:00am—12:00pm and 1:00pm—4:30pm Monday through Thursday;DCD is closed on Friday. All emails sent to and from this address will automatically be archived by Jefferson County and emails may be subject to Public Disclosure under Chapter 42.56 RCW. 1 ?J r 4?-1-I'LL- -' ,, I 1\-. 9.4-T5t- (3)„, , • r __------, Ei Lr, 1 g3.-'I Cr) I . ....AQ. �' G - S I ".............. El `� `? — �- O IC i< ...t 0 p 3 (-4- , ,._,., vii 1 .._... . f • A • .....1 vil \... , ....... 1 ‘4..) n , ...... , ..... , , s. ...,,. .....e d v-, v, .- ; , , ... (.4 (....D.- L '...... .., ,, ,3-, ›.... , <__________j A I 5 w z :4453E411,';0 g , 1 1aNYQP s •; g ja .�.. E'er 414 -01 • . ... 1 ... 1 h t-, g- it a .: 4.41_ n • I , 4 47-, 615 Sheridan Street n Port Townsend, WA 98368 www.JeffersonCountyPublicHealth.org Y 9 Public Hea . March 24,2015 El Sueno Kenneth Kinann/Jim Lobato 26 Duckabush Road Brinnon,WA 98320 Re: Plan Review Letter for El Sueno, 1433B Sims Way,Port Townsend,WA Dear Mr. Kinann&Mr.Lobato, The food service establishment application and plans submitted for El Sueno located at 1433B Sims Way, Port Townsend, WA 98368 have been reviewed by this office according to the Rules and Regulations of the State Board of Health for Food Service Sanitation,WAC 246-215 and Jefferson County Ordinance 6-05. The results of the review are detailed below: The following items are approved for use: 1. Floor Plan(Black pen diagram) 2. Site Plan(Submitted to DCD on 2/12/2015) 3. Equipment List 4. Menu(Submitted 2/2/2015) 1. You submitted annual food service permit application on February 2'1,2015 but the date on page 11,next to your signature is December 5th,2015.You must correct this date prior to the pre-opening inspection. 2. You are approved to operate your food trailer as a mobile food service under the Food Code by JCPH. 3. Prior to the pre-opening inspection,you must also submit a copy of the approval letter or permit issued by Zoning/Planning Officials from Department of Community Development (DCD)that allows you to operate mobile food service outside city limits. 4. Your proposed site of the mobile food service is10632 Rhody Drive, Port Hadlock, WA. You submitted a letter of permission from John Gunning, property owner of the Ness's Corner Building which allows you to operate your mobile food service at the parking lot at that location. If you change this base of operation,you must inform JCPH. 5. The Food Code states in part that: "mobile unit shall return to the commissary or servicing area for supplies, thorough cleaning, and other servicing activities"..... When not in operation a Community Health Environmental Health Developmental Disabilities Water Quality 360-385-9400 360-385-9444 360-385-9401 (f) Always working for a safer and healthier community (f)360-379-4487 El Sueno March 2015 13. As per the Food Code, storage of foods on mobile unit shall be done in a manner that protects foods from temperature abuse,pests,and environmental hazards.This means doors and windows that are left open during hours of operation must be protected by screens.You must also ensure that dry food items are stored at least 4-6 inches off the floor during hours of operation. Cold holding of potentially hazardous food(PHF)must be at 41 °F or less and hot holding of PHF must be at 135 °F or more. 14. Rest rooms must be readily accessible within 200 feet of the mobile unit during times of operation for use by food workers. You submitted a letter of permission from the owner of a commercial facility within the required distance,which allows El Sueno Food Workers to use the facility from 8:00 a.m. till 6:00 p.m., Mon to Saturday. Inspection of the rest room will be part of the pre- opening and future routine inspections. 15. The restroom agreement letter must be submitted every year to Jefferson County Public Health as part of the food service permit renewal process. 16. The septic review also requires that toilet facilities must be available at applicable locations. 17. The commercial building where the restroom is located is connected to an onsite septic system (OSS) so operations and monitoring(0 &M)inspection must be conducted on the OSS as part of the annual food service permit application in accordance with the septic code. You are compliant with this requirement as stated in item# 17. 18. An initial 0&M inspection was conducted on 2-19-2015 followed by a second one on 3/13/2015 to correct deficiencies.The current 0&M inspection report is good for one year and would expire on 3-13-2016. Please note that current 0 & M inspection report is required to renew your food service permit each year. 19. Mobile units must be inspected and approved by the Department of Labor and Industry(L& I). You are compliant with the requirement. On 3/17/2015 during a "walk-in" inspection of your mobile unit,the Food Inspector observed that a valid L&I sticker has been issued for the unit. 20. The Food Code requires that the waste water on the mobile unit be disposed or discarded by an approved method.You checked"yes"on page 10 about disposal of the waste water but you have yet to submit written approval from the Waste Disposal Facility. Please ensure you are compliant with this code prior to the pre-opening inspection. 21. All equipment must meet applicable American National Standard Institute (ANSI) or National Sanitation Foundation (NSF) standards or be of comparable design criteria. Domestic-grade equipment is not approved for licensed food establishments. 22. Provide air temperature measuring thermometers accurate within±3°F within all refrigeration equipment. } } Community Health Environmental Health Developmental Disabilities Water Quality 360-385-9400 360-385-9444 360-385-9401 (f) Always working for a safer and healthier community (f)360-379-4487 Map Output Page 1 of 1 ArcIMS HTML Viewer Map .‘, 1111111111 '5107303304 NZ.:3202 `-1‘,..:!..---1 •:.••124,:r:.,"2",•.:■ ',..12WLI',::•8 , ‘94.24X3 40/ 942.K.2•...:,. iii11~1.4. -,, •• — • ,. - , ',12?::,.!,4•.3.: , . ...t. s42.9assc,2 ..,,1,,,,....,4,...,:., ..., .6.K.,"":4 1... - ".1.12..e.).3b■-',3 ,,,, , '\--- , 1-----1----.' Sti ' ' *, 2.1‘.:'2,3"_4.:•!.. '[.. & '111-r ".-?•1.!,_•_•_.2" , sck 116 Chaffee St Legend ',-1.4'.-K,!.■,..■.:, , • c+.14'.4.:::,•e,C■2 SA 2:-.•:0::,::. Selected Features *A2S1'.41&4,1 ':.v1..."ti..:•-•12b JC Roads ' 44290370, 9•124,... 3 _ ".4•13,1:0'..:-:.,e1 Parcels-H Transitional Rural Zoning e'- Ic 942903706' ct,,,,Residenio,1:5 9•12,::".4+2,1 44.124-e?1-''' '' e. - 942903705 - --' -'- l3 ' ' Rerstsenitsi 1:10 442903704 94 3c0D::■ii it aral Restlentiai 1:20 'r.,12',...:■24--,2,..' Parts sn 0 Rectsat is,. Rural Wimps ec,I,- =i) `,..1.1•:,..,_ _. ....CdPaSEWASS4 942903803 '44' ' Ca nda 2 Rd III Cnrisroadie-CC 942903602 c429g380 'AM/X.:,.1 4 1 4.0V:44 ..., '!2,30'04 qa......4 0 moo os :42,44 .4,4 9,83ro4r41,4 i 'Lillian St J,,,......, 'L...7834:0503 9283‘..,.. ■ 1,...,611 FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection.Thu Mar 26 13:34:37 2015 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 3/26/2015 Donna Frostholm From: Susan Porto Sent: Wednesday, March 18, 2015 1:42 PM To: Donna Frostholm Subject: FW: Overnight parking @ commissary El Sueno fyi From: Mina Kwansa Sent:Wednesday, March 18, 2015 1:40 PM To:Susan Porto;Jared Keefer Subject: FW: Overnight parking @ commissary FYI—Please find forwarded the written permission from the property owner for Jim Lobato to park his food trailer overnight at the commissary. Susan could you please forward a copy of Donna at DCD? I don't have her e-mail address. Thanks, Mina Kwansa MPH, REHS/RS Environmental Health Specialist Jefferson County Public Health 615 Sheridan Port Townsend,WA 98368 (360) 379-4496 CONFIDENTIALITY NOTICE: This e-mail message,including any attachments,is for the sole use of the intended recipient(s)and may contain confidential and privileged information. Any unauthorized review,use,disclosure,or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. PUBLIC RECORDS ACT NOTICE: All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56. Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is exempt from disclosure under state law,including RCW 42.56. From:dramell @aol.com [mailto:dramell @ aol.com] Sent:Wednesday, March 18, 2015 1:33 PM To: Mina Kwansa; elsuenol @yahoo.com; amellfamily @aol.com; dramell @aol.com Subject: Fwd: Overnight parking @ commissary AMELL FAMILY LIMITED PARTNERSHIP 1943 PARKSIDE DRIVE CONCORD, CA 94518 JEFFERSON CO. HEALTH DEPT Mina Kwansa PORT TOWNSEND, WA 98368 1 To whom it may concern, Jim Lobato dba El Sueno LLC has the permission of the Amell Family Limited Partnership to park his portable (on wheels) coffee/misc. cart at our parking area in Port Townsend, WA. The address of the area is 1411 West Sims Way. If you have any questions please contact Michael Amell at 360.385.5500. Sincerely, Michael D. Amell Ptnr/Mgr. Amell Family Limited Partnership 03.18.2015 elsuenol( vahoo.com 360 821 1585 MKWANSA u CO.JEFFERSON.WA.US Original Message From: James Lobato <oscar40.il( dmail.com> To: dramell <dramell ci aol.com> Sent: Wed, Mar 18, 2015 1:07 pm Subject: Overnight parking @ commissary Jim Lobato El Sueno LLC elsuenol(c@vahoo.com 360 821 1585 This is Mina Kwansa email. Thanks again Mike. MKWANSA(cr�CO.JEFFERSON.WA.US 2 k0 - 41;7/ 17/0 C i wir , ` 4 (2.. ----r , _______, , .i (12- '-t-2C-eAr-C7 Lia.._,I b ,j , , .... , -I 4&-(- b 1 ()-(\.. 64-{ SI .C.{-( .,___P i r 110 0 od ejtv 11(\'(1 t VAA640 ,„,_c_e___} ,tc,( p____ Q(AA, ) fa % ---1:::)--- - ,,,,s,....ce,_ L- 04\SL_ .S\_.e.: '4'4 (-1 k", 2 (r - 011 105 i Y v-F ^1� 1/11/14 FEB 1 2 2015 '!J Consistency Review for Sally, L 'r� n��� i np r'T 18.20.182 (2) ;a COW ,TY r��r� We can be ready to move within 20 minutes.We are a mobile food trailer 5th wheel. It is only a matter of storing our propane bottles,loading our steps and hooking up to the truck. 18.20.182 (a) Although we are not required to have L&I because we do not have any employees,we do have the 14-15 L&I sticker on the food coach.We have a copy of the letter from the land owner,John Gunnie, stating we are renting his property and he gives his permission to park our food coach there.We also have a letter stating permission for our bathroom facility use. 18.20.182 Food coach is self contained with 50 gallon potable water tank and water heater.Also has a grey water waste tank that catches hand sink and dish water. Coach does not have bathroom.Tanks will be filled at commissary and dumped at Fairgrounds dump station every Sunday (or more often if needed).Will have very little waste water as it will only be used for dishes and handsink. Water for customers will be bottled water. 18.20.182 (d) Food coach has down riggers and will also be secured with wheel chalks so no unexpected movement will occur during operation. 18.20.182 (e) Food coach will be hooked up to shore power and is easily unplugged should we be required to move. 18.20.182 (f) There will be no decking, skirting, or any other ad ons or modifications done to the food coach,no seating, no tables. For Office Use: Date Rec'd Jefferson County Public Health _ Environmental Health Department Receipt# CG Amt 13'(' 4 615 Sheridan Street Case ID# Fac Type denresort 47,-----\\__ Port Townsend,WA 98368 Comments: Al. Tel: 360.385.9444 Fax:360.379.4487 , - Email:foodsafety @co.jefferson.wa 201) Public H vwv ealt Website: w.ieffersoncountypublichealt .orq ! tei 69 S 3 Z(f Food Service Establishment Application Packet New Food Establishments and remodeling Food Establishments must submit this application and accompanying documents and plan review fee**to Jefferson County Public Health (JCPH). Please allow at least 3 weeks to review all documents prior to opening,remodeling or construction in order to ensure that the needed documents are adequate,and/or allow for modifications that may be required. Once the Plan Review is complete and the establishment is ready for opening, call the JCPH for a pre- opening inspection at least 1 week in advance. Do not open without JCPH approval. "Plan Review fee(minimum 2 hours,$86.00 per hour=$172.00)payment is required up front. Additionally,Annual Food Service Permit fees will be determined upon completion of plan review. �ymf,# P , t.*�f - ,t, -;7t :,- - - ,. `4d e` s^ 4:4 C r- a 4.4,,, ,„.c.5e Y f-.i.^ ` L� `y, g ` z's fir; r .� - a,, , ` ! d„ ,* c 23 '.T This packet is for(Check one): P l e not be needed,please ation may o b n New Owner(Certain inform ❑ New Business ❑ Establishment Remodel ❑ e O ( Y P contact us for specific application requirements) ) Type of Food Service Establishment(Check any category that applies): ❑Restaurant ❑Bed&Breakfast ❑ Commercial Kitchen/Concession/Church ❑Restaurant/Take-Out ❑Caterer ❑Meat/Fish Market ❑Tavern ❑Espresso Stand ❑Mobile Unit. ❑Bakery ❑Grocery ❑ School Cafeteria ❑Other , El.—Name of Establishment C .5t4!E� ` ` .. 1. . _ ' 'y3-6 r. �` c �fi 7 1?�fe/ Gi 9£3bZ Address of Establishment u,.�aiff1�i�� T� P E-Mail et so who r0 yahoo •ebni Establishment Phone( ) up/..-/6-S- Manager/Operator Ito/vie-1h kirun() �,6;rn GD Phone#(�PD)(( S�t/-15k- Property Tax Parcel# Planned Opening Date ` tt4 t<,6! /,5 �((,,�� j� �j'' / / �o ( F Business Owners Legal Name keno ttht /�i nn %J/ate 141414E-mail (sr�d o•.L�l anal `ec Mailing Address ,,C 2)/.t it haZtul Rd, '/7,Ywul City State ZipOgig0 Bill To(check one) egal Owner En-Establishment Location Phone(,3jb 3a4 -/4,55 Days of Operation mon". ,4, 0 Hours of Operation ' f 4' �, in , 0 #of Seats in Food Establishment #of Staff(Maximum per shift) 4 '� Maximum Meals to be served(approximate number): Breakfast 0 Lunch 5 U Dinner Water Source(check one) Sewage Disposal(check one) Public r—On-Site Septic (Permit# ) Public/Municipal Well(State ID#) Ir Sewer I° (submit current monitoring inspection report) 61 l�Q I 1 of 11 Rev 12/14 cel 1 1 ar)() ---7:• \ (,) 6 z__, ) 1,-) ,I-, (-_-___„b - % ° OI C L t) ( 1,, , `,p C_ i 1,, -.)z % - t � s , Circle or answer the following questions as they pertain to your food establishment: t.Ple __ list allifoodanerethAt.are;,prepvei more,t.ktan 12 ho rs in advance ofs-rvice. VI •0 0 Lt1 1-/it 2.Will disposable gloves and/or utensils and/or food grade paper be used to prevent handling of ready-to-eat foods? rPt< /ENo 3.Will ingredients for cold ready-to-eat foods such as tuna,mayonnaise and eggs for salads and sandwiches be pre-chilled before being mixed and/or assembled? FIX5r/(-No If not ow will these be cool to 41°F? (1,0/2/- /S a--(if nearerf k dollen with mot fr di 4.Will produce be washed on-site? EYes Where will pr duce washing oc ur and describe the procedure for leaning and saniti i t e si ks and area between uses? tOcI Iva 1/ raQ,�� 41 &e at d a ii r ,, , Mite)c • / as tit gyp• /1 i• 5.Describe the procedure used for minimizing the length of time PH�F's will be�kept/in the temperature danger zone(41°F- 135°F)during-,14 tot j, /041i' X17 and &OE.R , / 1��'&e d y L' / Rte'/"11 7G ��' l) / I. >`, �/ i ri fq' '' or id-, f L._' ./ 6.Will foods be vacuum packaged on-site? Eyes /IwiVo Food Employees(Circle or answer the foil e. ' to your food establishment): 1.Will food employees be allowed to begin work without a valid'Washington State Food Workers Card? FEB 0 2'2015- EYes / If yes,please describe what type of training the new employees that have not yet obtained a valid Washington State Food Workers Card,will receive?Please explain the traingeftentOrt icadaRtWill be kept for the employees who had this training: Envi r r ental Health 1 ' i Miltrataral l /_' a. 01 ' &) ir totes k!e/i€/1d€, 2.Will food employees receive additional training in good food sanitation practic-s,above the required Washington State Food Workers Card? es /ENO If yes,please explain: _ ( c2Oc c tot)L / V Je At/ix/1S i rth l/®ues Mgr s A t e 1 . I ./g ,- ,L/I, i A!/1 I .1 141 3.Is there a policy to exclude or restrict food workers who are sick or have infected cuts and lesions? EYes r o Please attach include a copy of the policy or describe briefly: ¢ rf( a err ` and >ri t l/i /,werkrr7 % ,4 are Ill 3 of 11 Rev 12/14 cel Thawing Frozen Potentially Hazardous Food: Please indicate which thawing procedure will be used in order to thaw all frozen potentially hazardous foods(PHF's). More than one method may apply. Also,indicate where thawing will take place and which food items will be thawed. Check Thawing Method Thawing Location Food items to be thawed --rk f aia leli ri'1 y In the Refrigerator 1‘ Pod . ?eeit (-4z57--- Under Cold ❑ Running Water(less / /� 4 than 70°F(21°C)) •• / In the Microwave thaw / `; � � .j, J( ,p. ./ (As part of the pi ,jI0 wrtiAt / cooking process) l�! � / Zhee,0 Cooked From a 3 /g/e,• Frozen State �� �j� J J ❑ Other Cooking: RECEIVED Minimum cooking time and temperatures of product utfli tgkin1n and conduction heating equipment: Beef roasts JTt� er bui F Ltiu�1ty 130°F (121 min) Solid seafood pieces Environmental Health 145°F (15 sec) Other PHF's 145°F (15 sec) Eggs: • Immediate service 145°F (15 sec) • Pooled* 155°F (15 sec) (*Pasteurized eggs must be served to a highly susceptible population.) Pork 145°F (15 sec) Comminuted meats/fish 155°F (15 sec) Poultry 165°F (15 sec) Reheated PHF's 165°F (15 sec) Circle or answer the following questions as they pertain to your food establishment: 1.Will food product thermometers be used to measure final cooking/reheating temperatures of PHF's? Pres /[-No 2.What ty e of thermometers will be used to monitor temperatures(check all that apply): ( Metal-Stem Thermometer ( ) Digital Thermometer ( ) Thermocouple 3.Lis_t_ail types of coking quip ent that w' a used? 4+ �# /I V , te z r i� :i1 iP c ep -in fool: 4.Will there be any overnight cooking or cooking for extended unobservable time periods? Vs /1—No If yes,please describe how proper temperature monitoring will be don t......1 t�lit s+-4illir1L Mill CIA1111 'L A. Cii /t1 ' I /fat . j 1 5 of 11 Rev 12/14 cel 1.Are all insecticides/rodenticides used approved for food service establishments? fs /r-No Indicate chemical storage,location: al- Gin� c iw f , ' '' to ?dery 6/i11�- /4 a seen -/t/d a Ad, a i , ,� Orn ,. /ds. �i��:+ i / `1 2.Are all toxics for use on the premise or for retail sale(this includes personal medications), stored away from food preparation and storag• areas? ( /fNo If yes,please explain: a I /,tt) / ,/Ai// t' II -_ pi ! . /aI !.. %. I drn " F , y,ra i e7/ etb 3.Are all containers of toxics including sanitizing spray bottles clearly labeled? is /E-.No 4.What type of sanitizer will be used for food contact surfaces that cannot be submerged in sinks or put through ishwasher? Chemical Type: Concentration: Test KitFYes / 5.Will linens be laundered on site? 1-Yes /ENo If yes,what will be laundered and where? tv 13- If no how will linens be cleaned? I ,1 0� : ',e gel if/ , / :74 "/ , ,, _.011FLO 4 1 '-'1 010 i . 6.Where will clean linens be stored? - it, i , f 4e • (i .. T _ FEB 0 2 2015 7.Where will dirty linens be ored? 4siag.ery ..(Fp D I, ,../abet J.V-•)i,n n a eat 8.Are containers constructed of approved materials(food grade plastics and metals)to stores /1-No /ENA bulk food products? If yes,indicate t pe: aJ( 59 /,91/$s 9.Are all light bulbs that are located above food storage or preparation areas properly covered? I-Yes /ENO /ENA Insect and Rodent Control(Circle or answer the following questions as they pertain to your food establishment): 1.Are outside doors self-closing and/or rodent proof? is /(-No 2.Are screen doors provided on all entrances left open to the outside? I Yes No ro' IA 3.Do all windows that can open have a minimum#16 mesh screening? E_Yes /?. No e PfA 4.Will all pipes&electrical conduit cases be sealed;ventilation systems exhaust and intakes }'�l'es /ENo protected? �' 5.Is area around building clear of unnecessary brush,litter,boxes and other harborage? I k /7 No 6.Will air curtains be used? EYes / 10 If yes,where? 7 of 11 Rev 12/14 cel Garbage and Refuse(Circle,check or answer the following questions as they pertain to your food establishment): 1.Will refuse be stored inside,long term? (, ( f r-Yes /(qtr' If yes,where? —1 I/`0,..aa+'1)3 `5 k( t;(t A4--('. L< 2.What will be used for outside garba e storage? ( )Dumpster ( )Garbage Cans Number Size 950 Frequency of pickup-1241f Contractor 3.Will a trash compactor be use ? EYes /ENo Number Size Frequency of pickup Contractor 4.Where w the dur pste�Jr�/conmp r/ gar age ca s be store(? i 5 RECE .Where will returned or damaged goods be 1VPD—� "TOACEA 441 FED 0 ,?015 p ;gpll Lvunty Environmental Healt Employee Storage Areas(Answer the following question as it pertains to your food establishment): 1.Where will storage facilities for employees'personal belongings(i.e.,purse,coats,boots,umbrellas,etc.)be located? —Co 1 e. ( 11 i V eil-Wi.eA Water Supply(Circle,check or answer the following questions as they pertain to your food establishment): 1.Are floor drains provided&easily cleanable?Make sure they are shown on the floor plans. 1—Yes /F.N pJ lti- 2.Is the water supply public fl or private(i>`?' 3.If private,has the source been approved? Cis /[No /I—Pending *Please attach copy of written approval and/or permit. 3.Is there a bulk ice machine available? EYes /531-go If yes,please make sure that it is indirectly drained as indicated in the Plumbing Connections section on next page. 4.Will ice be purchased commercially q Jr s /(-No 5.Please describe provision for ice scoop storage: _ _ t i C4_ Noun, r1 , ).. mkti C,►r ct and t-tai- was will be- Si id 1J/ite onl 1 6.What is the holding capacity and heating capacity of the hot water heater(s)?,.. a/ kaki- Jletzief 7.Is there a water treatment device? 34 /ENo If yes,how will the device be inspected&serviced? 11Q 4v SyS4 -!'G 6.How are the backflow prevention devices inspecte d-A servic d? �it- LA petitivbA, tul,jer s in 9 of 11 Rev 12/14 cel r Sinks(Circle or answer the following questions as they pertain to your food establishment): 1.Is a service sink(mop sink)present? Cvres /(No If no - d- cribe wh-re and how mo s and other equip lent(e.g.floor mats,hood filters,etc.)will be cleaned? m G, t K,4' (i--FCC- .i yi 3.Is a food preparation sink present? es /I—No If no,please attach or describe all procedures used to properly wash produce,clean seafood,thaw raw meats and seafood and thaw cooked foods? 4, gCrkl- MC;'i FOOD S Complete this section only if submitting application for a mobile food unit: I.Where will be your food preparation site? Mobile Unit Commissary fr Other(specify) 2.Is there a commissary licensed by Jefferson County Publi Health for the Mobi - Food Unit? Xes /1"-No Commissary Name and Address: ,�/��.!/%! /'/1U/1/I///i„'L��%+�'ttf 3.List 'ddress of all parking to Lion/s�(if fneed at .ch f ap showi . all park*/ g loca ion ,ad. .l ses . d ti -s): ii_%.l�.ii -7-f- ilkl l4,.11 -- 41'r-Ad'li `_`/t Mme%��`�46wi�7 _ it' __--- t� • 1 Mail J/ J<�Yl �f+ K. °" L 1 °x`14'" 4.What is the License Plate#for the Mobile Unit? h if/54M/f{/ ?/ Yz. �r �� /b 5.Has Washington State Department of Labor&Industries inspected _and approved the unit? es /� to / �� ,,,,,If yes,what is your vendor#? (This can be found on the L&I sticker) iniii IT The undersigned manager or owner does hereby make application to operate a Food Establishment in compliance with the Rules and Regulations of Washington State(WAC 246-215)and the Local Board of Health Ordinance Chapter 8.05 Jefferson County Code. The above information,supplied by me,is true to the best of my knowledge. RECEi\ft: I UNDERSTAND THAT: 1. Permits are renewable annually and expire January 3151. Permits shall be renewed before expirativnBL�ali qu�tltq plications and/or permit fees may result in closure. ��CCDD tt➢➢ ff UU II 2. Permits are non-transferable,and are valid only for the current operator and the establishment] i to act9MAgli.Changes in the operation or location of the food service establishment require prior approval by the Jegvispitr§pwppertztail-tinleecitIllublic Health. Additional requirements,documentation and/or permits may be required.Approval of these plans and specifications by the Jefferson County Department of Public Health does not indicate compliance with any other code,law or regulation that may be required--federal,state,or local. It further does not constitute endorsement or acceptance of the completed establishment(structure or equipment). 3. No new permit will be issued to persons or businesses that are not in compli. ith urro t the current rules and regulations listed above or that have an outstanding debt owed to the Jef- ..n County Dep. of,'ub' Health. Im .� Lo ,:,,// �.., Jr Ir. 'cam--/5 Printed Name �'"re��� Date 11 of 11 Rev 12/14 cel lesA 44 IQ; i21541, ' . 46. 4: C gi Qp 5 40 ,L Aft 1 z tri RECEIVED 1111, 4 - FEB 0 2'1015 , ., Jefferson County Environmental Health i_ ■•■• •■• 21.442,titttgArtIV 0 ■■• /4%1%4041 Ica c/) 2 ......... 45 ei vc) , .g • 17 P t , Is ... ..... , 1 ........ ---- COMMISSARY LETTER The following business is approved to use MARKET KITCHEN NAME: " rvt "190-7-41) BUSINESS NAME: . EFFECTIVE DATE: DAYS/TIME: "V( k s. ?ca- Ca Renter LD6 • Print name 3---\--04/.. Loic,-t---0 374_ Date: Owner Print name - Date 1 - - C . / / / I I ; ' 6-747ruz,-u c eZe SCektD Z- Z-C--• 1.1 r I .,^‘ i , • ( ) ----/ rz 7 .../ / -, 0 ., ) ,, ,s---- , i ( ) _ 0(, .--,, o a ( a (3 7i / 1 - RECEIVED FEB 01'2015 Jefferson County Environmental Health 11' , 1 , 1 1 1 X ; % 4 , 111 / . .' 4-• a: ... . 1 , if, g 1 QA (-‘ .i Vion ---U 1.7. II ..a" in Z WROMIN...1 ,, , r • , 4 REECB Eo 2:2/01FD %IMMO 4.10 -40■1 5 Jefferson County , 2tietAtAtftl 7 OUT Environmental Health 400. ...so 0. _......... ...... ........ toti.V. 1 ........ 433 ........ ......,„ Z. ■••or aria I Sr Si W 010•■•• ig 41■Ra. ■••■• f .......... 1 Plan pages 1. Scale drawing of floor plan 2. a. Isometric drawing of Clean water lines b. Attached scale refference to Clean water lines 3. a. Isometric drawing of Drain lines b. Attached scale refference to Drain lines 4. a. Isometric drawing of gas lines (gas lines and appliances were factory installed when unit was factory made) b. Attached scale reference to gas lines 5. Electrical system drawing II Ii EEB 0.201 Jefferson County dironmentaI Health • ,1 .P.i if f Aliwit-v . 4,4 is -3.,Ft -4 alts-fr- t*.'L 16 U ';',.- 1‘!‘" -alagrainalausp... '114;11.01., ili* ', , „•,,e 'O.‘, i,,.. ', '- ' ,' _ ' '':--.... El Sueno Food Coach , / H _i Spanish Fusion Food .___ __• _, ,....,__-__...- ----- (360)-821-1585 ii luck i \i'r A., 1 vA s ) I besayuno cLs,, k-, 1.,,--,i_Lci v,, , RECEIVED FEB 0 21015 ' Breakfast' (' Jefferson County Servediram-11am Env,roflmeflta l Health vkkA/Vt4 ( P 6-C1 — ---TORTICUrESP-ANOL-A , U1--k_OL-k' Like a frittata crossed with an omelet. Spinach, eggs, potatoes, oni ns, serrano ham and monchego cheese. Served with fried potatoes drizzled with chipotle mayo and b-e--- salsa verde 1/4;51-1Lt)ii v1„,t tui,i< TORRIJAS cir Spanish french toast. Brioche soaked in sweetened condensed milk, dipped in egg, fried to perfection, served with a side of cinnamon infused maple syrup. SOPAPILLAS cfil Crispy, golden brown, spanish fry bread triangles, dusted with powdered sugar, drizzled in your choice of strawberry syrup or honey Ci-teRIZ" Our version of a breakfast sandwich. Chorizo, avocado, melted monchego and queso fresco, roasted pablano peppers, topped with an egg over easy and served on a Bolillo roll with a side of salsa verde _ELACAWANCA*ITAIRREAS CARAMEL APPLE EMPANADAS Pastry dough, stuffed with our caramel apple filling, fried then dusted with powdered sugar and drizzled with our cinnamon, caramel glaze BREAKFAST BURRITOS House made tortilla stuffed with scrambled egg, manchego cheese, potatoes, roasted jalepenos, fresh avocado, your choice of chorizo, steak or groundbeef,topped with queso fresco and served with a side of our salsa verde M lour prrri r c' ri -topped with queso fresco, served • e a AO a. , , - . , r . 'se of patatas--bra—ns ALMUERZO Y CENA 'Lunch and dinner' Served llam-6pm FEB 0 2'2O 15 Jefferson County Environmental Health TAPAS 3 II - : Chicken wings, fried then tossed in your choice of either our sweet chili BBQ or hot sauce. Served with a side of our house Bleu Cheese dressing JALEPENO POPPERS Fresh jalepenos, stuffed with pepperjack, cream cheese, bay shrimp and bacon, dipped in tempura batter then fried. Drizzled with crema. SOPAPILLAS Crispy, golden brown, spanish fry bread triangles, dusted with powdered sugar, drizzled in your choice of strawberry syrup or honey Savory Empanadas Pastry dough stuffed with manchego cheese, onion,and your choice of chorizo, pork or steak. Served with our salsa verde for dipping TACOS Y BURRITOS 3 TACOS Sc hl kV Canle-a.. d 0 ' your choice of Carnitas,1Set grak+nd-beef or chicken, served on corn tortillas with chopped lettuce, topped with our pico de gallo, fresh avocado, queso fresco and served with our house salsa verde BWINtiiii BURRITO . k. Pa./Fit House made efried beans, spaiee, guacamole, fresh tomatos, lettuce, cheese, , onion and your choice of Carne Asada, Chicken, Carnitas (pork), or Ground Beef, all wrapped up in a big house made flour tortilla and served with sides of Pico be Gallo and Chile Verde (option to smother in pork green chili for $1) Cam,,- - 1` kC uxiVO E g ti BOCADILLERIA FEB 0 2 2015 'Sandwich Bar' Jefferson County al Environmental Health BOCADILLO DE JAMON Serrano ham, manchego cheese, fire roasted piquillo peppers and chipotle mayo, served on a fresh baguette with a side of our creamy balsamic slaw BOCA DILLO DE CARNE Steak, queso fresco, fire roasted pablano peppers, sauteed mushrooms and onions, ,served on a fresh baguette with a side of our creamy balsamic slaw. stas-k\ ei-d-c, HAMBURGESAS Y bOGOS ' Hamburgers and bogs' THE SONORAN4 Bacon wrapped, sausage style dog, topped with salsa verde, pico de gallo, fresh avocado, fire roasted jalepenos and carmelized onions. Served on a fresh Boliilo bun brushed with mayo and top it all off with a drizzle of Crema *ALL'ArGERS MADE WITH LOCAL ORGANIC GRASS FED BEEF AND SERVED WITH HAND CUT FRIES* CHEESEBURGER 1/41b patty, cheddar and jack cheese, lettuce, tomato, onion, di jon mayo served on a ciabatta bun (add bacon for $1) MEXICAN HAMBURGER 1/4Ib patty, queso Fresco, fresh avocado, onion, lettuce, tomato, refried beans, wrapped in sopapilla 'fry bread', smothered in pork green chili and crema KITCHEN SINK BURGE'-'' 51\ I ( 0b ( 21/41b patties, lettute, tomato, carmelized onion, sauteed mushrooms, fresh avocado;?pepperjack cheese, 4 strips of bacon, roasted pablano pepper and di jon -------„mayo served on a ciabatta bun Chili Pork Chili Verde Our house made, slow cooked, pork green chili served with housemade tortilla wedges. FEB 6 2-2,01, Jefferson County Environmental Health PARA LOS NINOS (For the kids) Quesadilla: plain cheese, (add ground beef or chicken for $1) Junior Cheeseburger: plain with lettuce and tomato on the side, served with fries DRINKS Mexican Hot Chocolate Rich hot chocolate infused with cinnamon, vanilla, nutmeg and a pinch of cayenne Coffee Jarritos Sodas: Assorted Bottled Water Brewed Ice Tea San Pelegrino: Assorted Pepsi, Diet Pepsi, Sprite, Rootbeer FEB Q2` 015 Jefferson County nvironmentat Health c •----- •„---„,.)(a 0 0 . .....a.t......,...................w...4.46"1,34........11......o.,......... 1 -r ...”‘ ' Pitio -r"--11)0 • j_., 5 - a• ......, . .. _. . ... . . .. ... .. TY'i6pii(e ,r2e . . . , i - ,•. / ,...,. . i. •6'... : t•-• ''.'r " : **lit /..._.5 ... , ., . 11. i .7, i BR 1 /. sac 13arner ID. . . , mi si-ree. 1. i2o-1- /E0/7 ill ... 4. ., ... . . II 6, .'r. 1 Sewn • ll • • . ... _ . . i goof -/abk 4 fi 4,,..'.4 9,44,---- RECEItti----0 rad .. .,' :,. FEB 0 2215 le. hzezer Jefferson County Environmental Heat —7, eh(lief 0 f. 3 Comp. 1 . StWk i. ...._12.• . 1 .............._..,..,_,.. . cp. ilardsnA I . . I 4, 1 /P. orddr . , et. i. , .. m4001-05 ' , 1 1. arde -..--....... . . .., /2 (14p " , . . . imeinets .. r.,,,.., ....s. ,. i-,f, ,,iv,,,i,:. ,„,'•,Ik_..)---, ,0-,e62 Iv • •- 0 ____j ri._ .7 vt. ,-___. ,,;"?... 61.4 .... A A..1 ■a "....A 15I. AV- wie I - /I , Pedef ., iii„6,,,, ,. . ...:.Y 7 WI 1 / 5 9 /j1 - '' \''t' ''' .1 '!, '-'• I,,A,-'t.:::i 1) IS' h)Ner 404 t ' i ' 4---.4 •.. — zi i I• b s .., :., . ,;: . 3• i ,:. I. ,,, ,,,,i , ., ,'„,,, ,• m . . ,....„ .,c , , I :,, - . 1 4 1. FreShk t 04 . i g. hidf k W4 3. Ellf-ru4lt•e rt--t ry 1 li. crpsh F1i 4017/071-10#4e4 0#4e4 li. WeitVie r‘ tt 1 4 z FEB 0.2 2015 1 Jefferson County ,, Environmental Health 2. i k F i -n 7, /L, 0--7,--- i (7-0/ I /0 i ; —"to 7 0-71,77-uvU c i g s ..• 07, r - / 2 1 J - i / , D-0 /--C i \N---5-- / / 4 a /1/69,c7 'S 7. 441 / IA te - y RECE/VFD . FEB o 2.2015 Jeffers or Environr:,CO3 u_nty -riLa! Health • , �� STATE S O.� 44 oe,STATE p� `., v sob e .z tats of ..�z► .1. 00 cuop I 41 2 tog , in Secretary of State I, KIM WYMAN, Secretary of State of the State of Washington and custodian of its seal, hereby issue this CERTIFICATE OF FORMATION to EL SUENO LLC a/an WA Limited Liability Company. Charter documents are effective on the date indicated below. Date: 12/10/2014 UBI Number: 603-462-207 STATR �. ;.C.. .... 0,,4) Given under my hand and the Seal of the State .... :::• of Washington at Olympia,the State Capital 0 .NOlA �'a. „1-y s " fr,Itio,.....___ 'e, 111/11 ,, v. .;ii y� Kim Wyman,Secretary of State 1889 a? Date Issued: 12/24/2014 r r y 4_ YV\i'1/4A°14 , 4►1 /, 5 _31Akti41--0(t-f-P_ ,44-gr' 7)-e lir.,t7,ke ,: 1.7.,) 4 mvtoIscizAj d_Li,ci. --. 2, R!Add >. /8. Z2 . 1 .. .-. (2-) 66 ) needs 6 ; i ---ir rnetrti , -o 0--F, )2,erc:-___. (-5-2;?' ,5--,-)?;,, Ct-M, r 413 E4 1 �.IL� 11 4 Lug 0 (d-) 0-6--c * AA.CI C-tfXrit-44.47 . .n ,( ('""',. _. ,,.t D� r o (c ) 14.14 y61Al is ? III i°11 0 C)p p CD ,., Rs in IN P 0—, cs■ c, - 0 / ',"s" ,, s4 '.-..v3 hi / su; L. �'l r e�.., ® - 00 . V 00 '" c) l�" `l�}yI rl� e V" ! ci*46 .96 ' CO')rir- Cil tiy I k..... ] 1,0 X C"'Li" ''' =:II lk). C71)...1 --% us C7 ru / ppr 1 1.,)1? ..9 i' 1 _ . 0 , , ("0 v... '' ''''''''Or . - , N I Uq N Ot? 4 0 z,( O O Q v) w n ti• FEB02.201� E 4.4Q 0,0 Jefferson County 77 t` . O 1 Environments! Health r, C n co 0 n t. O .� cs, lilts _ CD I 1r .. 1:1) _`0 � 4 4„.., -t':1) (1) 4 11111 c.n>4:(IQ: N cn / r 1 0 --i , Tr-, a r [1°71 r,.) ( I t 7 Irk ;-- pa li 1 C.)\'' I 5 ° " "O � � � � �� ' 7...... ,,,-—'Ts i ' -P • W ma 00 00 ab F Id L x ttL tb 1 C l 51i ''1 ) 1t= veil _ .... ,, . ...._„2...__v_..._4.,_:..4__________________ pINF- kni. 1C4L1 I. F. ..r.64411. 1.'1. V r) R • 117, ■-•71'd ...... ' ,'', - i VI . ril 'CZ rsjt g- . „g 0 ( iI N0 cu • ! 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X F,,_ .`': `-t gclta ec Release;Asse ly(Stainless Steel Caps } n;;,! ,:,; inless'.Ste,1 Tank.filled vwi r"ANS J EX wet cb is l low ph t 300 1 I �1ow Points) :.�"i : i dge LTI012f _ w t` T at uut Pull Station=;48 Inches above floor per rnstallaiion requiement Others.. see attach men for parts used_(An , Pages) let�um-,2 x 1 N) S No Range=•2 x 290,Duct//Iood I' p sul Manual Pa es APPLICANT CONTRACTOR/INSTALLER CHARLES WINGS AND SANDWICHES FIRE PREVENTION SERVICES,INC. I(kt32'. 15th Avenue SW 10520 SE 200th Street. Beattie,.WA 98146 Kent,VVA 98`0�l` Attent'on Alicia or Attention: ALEX J'AMI•FO (206)787-057? I1 SI'JOb150 Contractor-Lie.FIREPPS95I08 FEB 01 Jefferson County EnvironJe mental Heath • AIVSUL DESIGN INSTALLATION R-102 RESTAURANT E1RE SUPPRESSION 1 RECHARGE AND SYSTEM 1 1 M 1 1 AINTENANCE (Standard UL 300 Listed) MANUAL III III�i 11_ S WM M alow r MINN ga IMMO 1 • mew 1 RECEID V FEB 0 2 2015 , Ili , Jefferson County -,,-- Environmental Health IIII) . II II Ill (01106 • SECTION H-SYSTEM DES. UL EX.3470 ULC CEx747 ■ 8-1-01 TOTAL SYSTEM There are three types of R-102 Restaurant Fire Suppression Double-Tank System Systems: 1.Single-tank System The R-102 double-tank system is available with a stainless steel enclosure and consists of: 2.Double-tank System 1. ANSUL AUTOMAN Regulated Release Assembly (Electrical 3.Multiple-tank System or Mechanical) The type of system required for the particular installation will be 2. Nitrogen Cartridge and/or Carbon Dioxide Cartridge determined through the guidelines covered in "System Design." 3. ANSULEX Low pH Liquid Fire Suppressant Additional equipment which may be required to complete the sys- tem design is explained in the "System Components" section. 4• Enclosure or Bracket Assembly Additional devices covered are: remote manual pull stations, 5. Discharge Nozzles mechanical and electrical gas shut-off valves, electrical switches, and pressure switches. 6. Detection Components Single-Tank System 7. Additional Devices(As Required) The regulated release assembly contains the regulated release The R-102 single-tank system is available with a stainless steel ■mechanism, agent tank(ordered separately), expellant gas hose enclosure and consists of: for agent tank hookup, and enclosure knockouts to facilitate installing expellant piping,detection system,and additional equip- 1.ANSUL AUTOMAN Regulated Release Assembly (Electrical or Mechanical) meat. ■The enclosure or bracket assembly is mounted separately but 2.Nitrogen Cartridge and/or Carbon Dioxide Cartridge 3.ANSULEX Low pH Liquid Fire Suppressant within the guidelines of the regulated release assembly expellant gas piping requirements to ensure simultaneous actuation of the 4.Discharge Nozzles system.Refer to"System Components"section for individual com- 5.Detection Components ponent descriptions. 6.Additional Devices(As Required) The regulated release assembly contains the regulated release VII''mechanism, agent tank(ordered separately), expellant gas hose 111111 ;" '"' blur for agent tank hookup, and enclosure knockouts to facilitate _ •� .+'" '� installing detection system and additional equipment. Refer to ,,.__i.. - - �` "System Components" section for individual component descrip- ��ii.►-�"� ■ tions. --,c IN, �' 0 .....4.-."- � „.4-1 4 0--.----- - HO / ,..... 1 7 D 0 �c„ . --- .......„ 11, IIIII> FIGURE 2 000134 D ANT FIGURE 1 � _ �O 000133 a SO S 0 E� � © v`N^'J 0 nj\COQ • SECTION IV — SYSTEM DESIGN UL EX. 3470 6-1-91 Page 427 • REV. 1 DISTRIBUTION PIPING REQUIREMENTS (Continued) Distribution Piping Requirements — 3.0 Gallon System 1. The maximum length between the start of the first branch SUPPLY line and the start of the last branch line must not exceed TEE ~1 24 ft.(7.3 m).When the supply line is split,the combined ` ' total of both legs of the supply line(from the start of the .. , first branch line to the start of the last branch line)must not fft „ ' exceed 24 ft. (7.3 m). See Figure 65. 2. The total length of all branch lines must not exceed 48 ft. COMBINED LENGTH MUST NOT (14.6 m). See Figure 65. I 0 EXCEED 24 Fr.(7.3 m) 3. Use a 3/8 in.union to connect the tank adaptor to the 3/8 in..supply line. 4. A maximum of two nozzles are allowed per duct branch line. ► 5. The requirements of the following table must not be exceeded: 2WH NOZZLE 1N NOZZLE ■ IN NOZZLE 112N NO771 F / 1W 1/2N NOZZLE • NOZZLES NOZZLES (BRANCH LINES IN BOLD) COMBINED LENGTH MUST NOT EXCEED 48 FT.(14.6 m) FIGURE 65 Duct " Plenum Appliance Requirements Supply Line Branch Line Branch Line Branch Line Pipe Size 3/8 in. 3/8 in. 3/8 in. 3/8 in. Maximum Length 60 ft. 8 ft. 8 ft. 16 ft (18.2 m) (2.4 m) (2.4 m) (4.8 m) Maximum Rise 12 ft. 4 ft. 2 ft. 2 ft. (3.6 m) (1.2 m) (.6 my-- (.6 m) Maximum 90° 9 8 8 8 Elbows Maximum Tees 1 2 1 4 Maximum Unions 4 2 2 2 Maximum Flow 12 4 1 4 Numbers rze,celVg) ,� 0\ ,_z\F\4': SECTION III—SYSTEM COMPONENTS UL EX.3470 ULC CEx747 Page 3-1 10-1-02 REV.3 EXTINGUISHING AGENT ANSULEX Low pH Liquid Fire Suppressant(1.5 gallon—Part No "ANSUL AUTOMAN"REGULATED RELEASE ASSEMBLY 79694 or 3.0 gallon—Part No.79372)is a potassium-based solu (MECHANICAL) tion designed for fast knock-down and suppression of grease- related fires.The agent is shipped in plastic containers which pro- vide one complete tank charge.Agent storage life expectancy is ° ' :� twelve years.The distributor must record the batch numbers and - • OR SEE AGE 3-4 SLY date of shipment receipt to be filed with each installation record. -ANSULEX"LOW pH LIQUID FIRE SUPPRESSANT RELEASE ardriN •�►. MECHANISM ..„...Jo 1 ____-, Ott ' '...iI 4400:40 3.0 GALLON 1.5 GALLON ■ SHIPPING WT.35 LB.(16 kg) SHIPPING WT.19 LB.(9 kg) I A REGULATOR 000138 000137 - FIGUR SHIPPING WT.25 LB.(11 kg) REGULATED RELEASE ASSEMBLY(MECHANICAL) si.° g FIGURE 2 The ANSUL AUTOMAN Regulated Mechanical Release Assembly coo'. �k t,t 009138 (Part No. 429853) contains the regulated release mechanism, RE ` expellant gas hose for agent tank hookup,and enclosure knock- SASE ASSEMBLY(ELECTRICAL) outs to facilitate installing actuation piping;expellant piping;detec- T 2 AUTOMAN Regulated the mechanical l version Assembly exc except it tion system; and additional equipment. This regulated release •also nt contains a factory identical installed the mechanical vdrand lecept it assembly is used in single,double,and multiple-tank systems and swit contans a factory installed 120 VAC solenoid and electrical must be mounted to a rigid surface.The release mechanism can switch. "The solenoid is used to provide electrical actuation of the release be used to interconnect both the actuation and expellant gas lines as required per system design.The regulator is designed to allow mechanism.The electric switch is used to protect the solenoid b a constant flow of gas into the tank at 110 psi(759 kPa)when the opening the circuit to the solenoid once the system is fired system is actuated.The agent tank must be ordered separately. Additional electrical switches can be added as required for auto- In single,double, and multiple tank systems, the provided expel- matic equipment and gas shut-off accessories,as well as initiating lant gas hose connects the agent tank to the bottom outlet of the audible and visual alarms. regulator. In double and multiple-tank system configurations, the back outlet of the regulator is used as an expellant gas feed for "ANSUL CAOMAN"f EGULATED RELEASE ASSEMBLY AL) one additional tank-enclosure or tank-bracket hookup.The enclo- sure contains the required knockouts to facilitate this connection. If a pressure switch is to be attached to the regulator,additional fit- tings are required. NOTE:AGEBE OR TANK MUST Vb o SEPARATEL D e. •The tank (ordered separately) is mounted within the enclosure. ' OR SEE PAGE 3-4 7 The tank contains an adaptor/tube assembly with a burst disc ` �t union.The burst disc helps prevent siphoning of the agent up the ,�sF' y{` i pipe due to significant temperature fluctuations in the area where REGULATOR Jl SWITCH the tank is located.The tank is mild steel and, under normal con- irj�ywh;{� ditions,requires hydrostatic testing every twelve years. - ►Ijy` The detection and additional equipment required per system i' design are connected to the release mechanism. The enclosure �p�� SOLENOID contains knockouts to facilitate detection and additional hookups. "'r `p The system can be actuated automatically or manually.Automatic actuation occurs when a fusible link within the detection system IIIII .11100, separates in a fire condition. Manual actuation of the system occurs when personnel pull on the remote manual pull station pull ring. T.SHIPPING W 34 LB.(15 kg) FIGURE 3 000139 i SECTION III—SYSTEM COMPONENTS UL EX.3470 ULC CEx747 Page 3-4 REV. 5 10-1-02 •ADDITIONAL SHIPPING ASSEMBUES GAS CARTRIDGES Several complete shipping assemblies are available containing The R-102 system uses gas cartridges to store nitrogen or ca ..,* both the release or actuator mechanism and the agent tank.When dioxide expellant gases under pressure until the system is actuat ordering a complete shipping assembly, order the following part ed,at which time the cartridge seal is punctured and the relea -s numbers: gas expels liquid agent from one or more tanks through the dis- Shipping Wt. charge piping and out the discharge nozzles. Part No. Description lb. (kg) Four nitrogen gas cartridges and three carbon dioxide gas car 430299 3.0 Gallon Mechanical Release 33 (15) tridges are available as shown in Figure 12. Shipping Assembly including: 'Cartridges noted as TC/DOT are both Transport Canada(TC)and 429853 Mechanical Regulated ( Department of Transportation (DOT) approved. Cartridges noted Release Assembly •as DOT are Department of Transportation approved only. f,'; 429862 3.0 Gallon Tank Assembly Cartridge selection g options are provided in Section IV under Tank;' 430300 1.5 Gallon Mechanical Release 30 (14) and Cartridge Requirements. Shipping Assembly including: NITROGEN GAS CARTRIDGES 429853 Mechanical Regulated Release Assembly 429864 1.5 Gallon Tank Assembly } 430309 3.0 Gallon Regulated Actuator 36 (16) ."� Shipping Assembly including: ;(20�) (2a 9 cm) (210 7 v2 IN• 429850 Regulated Actuator Assembly (2T`x°) 14 5/s w- 429862 3.0 Gallon Tank Assembly (37.1`"") 2 1/21N. 430316 1.5 Gallon Stainless Steel Enclosure 18 (8) (6•4 Cm) ( ) 21/21N. 43/161N. Shipping Assembly including: (6.4 cm) (10.6 cm) 429870 Single Tank Mounting Box Assembly 9/1s IN. t9�) 429864 1.5 Gallon Tank Assembly LT-20-R LT-30-R DOUBLE-TANK LT-A-101-30 CARTRIDGE CARTRIDGE CARTRIDGE cA(RTRIDGE 430317 3.0 Gallon Stainless Steel Enclosure 20 (9) PART NO.423429 PART NO.423435 PART NO.423493 PART NO.423491 • (TC/DO) (TG/DOT) ( rc/DOT) Shipping Assembly including: 000105 X1,6 000147 (T o� 429870 Single Tank Mounting Box Assembly CARBON DIOXIDE CARTRIDGES 429862 3.0 Gallon Tank Assembly 430324 6.0 Gallon Stainless Steel Enclosure 40 (18)' - Shipping Assembly including: 429872 Two Tank Mounting Box . 9 IN 7 7/8 IN. Assembly (22.9 cm) (20 cm) 429862 3.0 Gallon Tank Assembly(2) (29..5 5 cmm) (1 . 430332 3.0 Gallon Mounting Bracket Shipping 20 (9) y Assembly including: I 2N. 429878 3.0 Gallon Mounting Bracket 21�I J g t 2N•(5.1 cm)"� (6.4 cm) Assembly �. 429862 3.0 Gallon Tank Assembly 21/2 IN. • (6.4 cm) 101-10 CARTRIDGE 101-20 CARTRIDGE 101-30 CARTRIDGE • PART NO.423439(TC/DOT) PART NO.423441 PART NO.423443 • PART NO.15850(DOT) (TC/DOT) (TC/DOT) 000149 000150 000151 FIGURE 12 RECE1 V FEB ® ` 2°1' g Environs' I • l • SECTION III-SYSTEM COMPONENTS UL EX.3470 ULC CEx747 Page 3-6 tt REV.4 10-1-02 �' CONDUIT OFFSET ASSEMBLY "COMPRESSION-SEAL"ADAPTOR The conduit offset assembly, Part No. 79825, is used to change This adaptor is a mechanical bulkhead fitting that pr.* direction of the wire rope on detection,mechanical gas valve,and liquid-tight seal around pipe and conduit when installing remote pull station lines.The conduit offset assembly can only be tion piping and detection conduit through restaurant h... ,"; used in the area where the conduit attaches to the regulated ducts. The "Compression-Seat" adaptor is a straight release assembly. When using the conduit offset assembly, the design requiring no cutting or threading of conduit or pipe.;; maximum number of pulley elbows is still allowed. The Conduit adaptor is available for pipe sizes of 1/4 in. (Part No.791-K,;` Offset Shipping Assembly, Part No. 79825, consists of 6 conduit in. (Part No. 79150), 1/2 in. (Part No. 79146), and EMT *'.„. offsets. size of 1/2 in.(Part No.79152).Each"Compression-Seal” •*° " CONDUIT Shipping Assembly must be ordered as stated below: ' . �—COUPLING i Shipping Assembly Hole -- _.. Size Part No. Qty. Req - ` ''; 1/4 in. Pipe/1/2 in.tube 79149 24 3/4 in. OFFSETT 3/8 in. Pipe/5/8 in.tube 79151 24 1 1/8 in. ., til 1/2 in. Pipe 79147 24 1 1/8 ism . 1/2 in. EMT Conduit 79153 24 1 1/8 CONDUIT I COMPRESSION NUT. �.'.N: CONNECTOR , i � 0 .4. ADAPTOR BODY GASKET-� LOCKWASHER FIGURE 17 NUT ��. 000153 "QUIK-SEAL"ADAPTOR FIGURE The"Quik-Sear adaptor is a listed mechanical bulkhead fitting that produces a liquid-tight seal around both distribution piping and "HOOD SEAL"ADAPTOR ASSEMBLY detection conduit which runs through restaurant hoods and ducts. , This adaptor is a mechanical bulkhead fitting that produces a The "Quik-Seal" adaptor accepts threaded pipe or conduit. The uid-tight seal around 1/2 in.EMT conduit when installing the*. adaptor is available for 1/4 in. (Part No.78195), 3/8 in. (Part No. tion line through restaurant hoods and duct.The adaptor .►►-'a. 77284), 1/2 in. (Part No. 77286),or 3/4 in. (Part No.77288)pipe a high temperature pulley elbow and, when used, correctly x` or conduit sizes. When using with EMT conduit, a conduit con- , tions the elbow or conduit in line with the conduit adaptor . ., nector must be installed in each end of the adaptor. The "Quik- the detector bracket.The"Hood Seat'eliminates the need for fi" Seal"Adaptor Shipping Assembly must be ordered as stated tiple elbows when penetrating the top of a hood when installing below: detection line."Hood Seai"Adaptors are available in quan 1-47=- Shipping 6 as Shipping Assembly Part No.423253. Assembly Hole Size Size Part No. Qty. Required SEAL NUT 1/4 in. 78196 24 3/4 in. r 3/8 in. 77285 24 1 1/8 in. SEAL t iii / WASHER 1/2 in 77287 24 1 1/8 in. ADAPTOR 3/4 in. 77289 24 1 3/8 in. BODY ...-1. ---- ADAPTOR BODY T GASKET LOCKWASHER GASKET PULLEY �1 LOCKWASHER ELBOW �!I_IR aI!I �� (NOT PART OF ASSEMBLY) ..�-�` NUT USE ONLY PULLEY ELBOW,PART NO.423250 FIGURE ',. FIGURE 18 ... � o� , .., .___i__.....a.../ Tht.,--ii, Li • Jeffers. _ + ,, %; Envlrortor ,. SECTION Ill-SYSTEM COMPONENTS UL EX.3470 ULC CEx747 Page 3-7 10-1-02 REV.4 DETECTORS CLIP-ON STYLE—PART NO.56837 AND 56838 The detector consists of three basic components:the bracket,link- age, and fusible link. (Fusible links are not included and must be ordered separately.)The bracket holds the entire assembly to the (BLE mounting surface.The linkage is used to support the fusible link. LINKAGE BRACKET The fusible link is designed to separate at a specific temperature %� j and release the wire rope,thereby actuating the regulated release �.�1 I,. mechanism. .1—� _ 000157 There are three styles of detectors available:the clip-on style,the HINGED STYLE—PART NO.15373 AND 15375 hinged style,and the scissor style. The clip-on style allows the wire rope to be strung completely p t / through the detection system conduit and brackets first and the detector linkage assemblies are then clipped on later. LINKAGE NNak FUSIBLE The hinged style detector requires the wire rope to be strung to the LINK BRACKET detector bracket,and then"threaded"through the linkage assem- - - bly before continuing to the next detector bracket. m P.m -----------....N 6\\ The scissor style allows the wire rope to be strung completely �'"'�"�f I through the detection system conduit and brackets first and the �� detector linkage assemblies are then clipped on later. SCISSOR STYLE— - ,.. 17368 AND 417369 Each style of detector consists of two types of assemblies: BRACKET The Terminal Detector (Part No. 56838, 15375, or 417368) LINKAGE.. 046 /includes a test link and is placed last in a series of detectors.This detector is sometimes referred to as the end-of-line detector and is thus named because it is at the point at which the wire rope"ter- FUSIBLE A minates,"or is anchored at the detector bracket.Only one termi- LINK nal detector is required per detection system. The Series Detector(Part No.56837,15373,or 417369)is any 5 detector located in-line between the regulated release assembly Fl E 21 and the terminal detector. PULLEY S When using Part No.56837 and 56838 style detectors, a total of There are two types of pulley elbows used to change the direction 12 detectors can be in one detection system: 11 series detectors, of the wire rope by 90°.Ansul recommends for temperatures not Part No.56837 and 1 terminal detector, Part No.56838. in excess of 700°F (371 °C). Part No. 415670 has socket ends When using Part No. 15373 and 15375 style detectors,a total of with set screws for 1/2 in.conduit,and Part No.423250 has corn- 5 detectors can be in one detection system: 4 series detectors, pression ring ends also for 1/2 in.conduit. Pulley elbows must be . Part No. 15373 and 1 terminal detector, Part No. 15375. ordered in quantities of 50 as Shipping Assembly Part No.415671 When using Part No.417368 and 417369 style detectors, a total (socket end type)and Part No.423251 (compression end type). of 15 detectors can be in one detection system: 14 series detec- PART NO.415670 PART NO.423250 tors,Part No.417369 and 1 terminal detector, Part No.417368. ie -- r i®i II .10. 000160 000161 • FIGURE 22 CEINIF,,,D, ' RE , ,, vE, c, ;z 70', t _ :.: s , 3efterso;, )._, ,, _ . Ei vironn`o �.._ SECTION III–SYSTEM COMPONENTS UL EX.3470 ULC CEx747 Page 3-8 REV.5 10-1-02 MECHANICAL GAS VALVES PULLEY TEE The Pulley Tee(Part No.427929)is a in change the direction m- The to the mechanical n upon ctuation designed to shut of the flow p two wire ropes within by 90°. It must be bly.The valves are available in sizes of 3/4 in., 1 in., 1 1/4 peratures are within the range of 32°F to 130°F(0°C to 54°C). Y• Pulley tees can be used in mechanical gas valve actuation lines 1/2 in.,and 2 in.Ansul style;and 21/2 in.and 3 in.Asco s are and remote manual pull station lines.Pulley tees cannot be used valves are rated for natural and LP gas.Both styles ax mum UL within a detection line. Part Operating O �I 1 Description Pressure ��', ® p ttt� 55598 3/4 in.Gas Valve(ANSUL) 10 psi(69 55601 1 in.Gas Valve(ANSUL) 10 psi(69 k — 55604 1 1/4 in.Gas Valve(ANSUL) 10 psi(69 k• 11111 55607 1 1/2 in.Gas Valve(ANSUL) 10 psi(69 k• 55610 2 in.Gas Valve(ANSUL) 10 psi(69 k FIGURE 23 25937 2 1/2 in.Gas Valve(ASCO) 5 psi(34.5 V ppp8A7 25938 3 in.Gas Valve(ASCO) 5 psi(34.5 STAINLESS STEEL CABLE ...-_,4• �, The 1/16 in.stainless steel cable is run from the terminal detector, ° through conduit, all series detectors and pulley elbows,and into the regulated release mechanism trip lever.When any fusible link N separates,the tension on the cable is relaxed, and the trip lever actuates the regulated release mechanism.The cable can t�ationc used for mechanical gas valves and remote manual pull • �-----/' The cable is available in 50 ft.(15 m)(Part No.15821)and 500 ft. ` 1' )� (152.4 m) (Part No.79653)lengths. "` I `` REMOTE MANUAL PULL STATION ANSUL STYLE Asco srrLE 000184 000165 The remote manual pull station(Part No.4835 or Part No.54011) FIGU is required for manual actuation of the regulated release assem- bly.The remote manual pull station should be mounted at a point of egress and positioned at a height determined by the authority •having jurisdiction.Trim rings, Part No. 427074(pack of 10),are •available. PART NO.4535(WITHOUT CABLE) PART NO.54011(WITH 50 FT OF CABLE) el U METAL STAMPED 000163 FIGURE 24 FER 0 2 2Q Sett:rsob 1 count t.1 tt° Environment"\ 1-lica • SECTION IV — SYSTEM DESIGN UL EX.3470 ULC CEx747 Page 4-5 10-1-02 REV.3 Plenum Protection The R-102 system uses the 1W Nozzle(Part No.419336)or the ►1100 Nozzle(Part No.430192)or the 1N Nozzle(Part No.419335) , t for plenum protection.The 1W nozzle tip is stamped with 1W and 20 IN.(51 cm) ►the 1N nozzle tip is stamped with 1N,indicating they are one-flow MAXIMUM nozzles and must be counted as one flow number each. When protecting a plenum chamber,the entire chamber must be protect- .ed regardless of filter length. . -0" 1 IN.(2.5 cm) MINIMUM •VERTICAL PROTECTION—GENERAL I i ►One 1W nozzle or 1100 nozzle will protect 4 linear feet(12 m)of t plenum.The maximum distance from the end of the hood to the ' 20 IN.(51 cm) first and last nozzle must be no more than 2 ft.(.6 m).After the first MAXIMUM nozzle, any additional nozzles must be positioned at a maximum I j of 4 ft. (1.2 m) apart down the entire length of the plenum. The ►plenum width must not exceed 4 ft.(1.2 m).(The 1W or 1100 noz- 1 IN.(2.5 cm) zle can be used on single or V bank filter arrangements.) See MINIMUM ►Figure 6. 2 Fr.(.6 m) . +; MAXIMUM .-1," I. 7 4Fr.(1.2m) 000199 MAXIMUM 4 4 F6(1.2 m) 4 Fr.(12 m) ' Option 2:The 1W or 1100 nozzle must be placed perpendicular, 2 Fr.(.6 m) MAXIMUM MAXIMUM 8-12 in.(20-30 cm)from the face of the filter and angled MAXIMUM to the center of the filter.The nozzle tip must be within ' w ��� 2 in.(5 cm)from the perpendicular center line of the fil- �'� ter.See Figure 8. iiiii �� 12 IN.(30 cm)\ ,.„ 0„• ..0", MAXIMUM L 41N. \‘, I i i / 81N.(20 cm) l-- .--"-----' 1�P MINIMUM ':' NOZZLE TIP i t MUST BE WITHIN ii' i FIGURE 6 THIS AREA �. 000197 .:°■� .When protecting plenums with the 1W or 1100 nozzle,two options of coverage are available: I,�''. 1-Option 1:The 1100 or 1W nozzle must be on the center tine of the ` FIGURE 8 single or"V" bank filter and positioned within 1-20 in. °0°200 (2.5-51 cm) above the top edge of the filter. See ► HORIZONTAL PROTECTION—OPTION 1 Figure 7. 1N NOZZLE—PART NO.419335—SINGLE BANK PROTECTION One 1N nozzle will protect 10 linear feet(3.1 m)of single filter bank • plenum.The nozzle(s) must be mounted in the plenum, 2 to 4 in. (5 to 10 cm)from the face of the filter, centered between the filter height dimension,and aimed down the length.See Figure 9. I / f 2—41N. 10 Fr.(3.1 m) ■ :. (5—10 cm) MAXIMUM Q1 000201 1 ..4 FEB ,,n.y -0.1\f° 30evsor° 0-‘ �' ` 990202 ► FIGURE 9 SECTION IV — SYSTEM DESIGN_ . UL EX. 3470 7-15-92 Page 4-10 REV. 1 NOZZLE PLACEMENT REQUIREMENTS(Continued) Fryer Protection(Continued) When defining hazard area for single nozzle coverage,it must fi 2. Low Proximity Applications: 10 to 26 in. (25 to 66 cm) include any metal surfaces between the actual grease pots- above liquid grease surface. See Figure 32. Example: If there are two fryers, side-by-side, each with a The 1W Nozzle(Part No.56927)is used for low proximity grease surface width of 18 in.(46 cm)and a metal ■ applications.The nozzle tip is stamped with 1W,indicating spacer of 1 in.(2.5 cm),this would not fa!l within the that this is a one-flow nozzle and must be counted as one area of coverage for a single nozzle.Two nozzles flow number. would have to be used,one positioned over each hazard area. See Figure 33. When using this nozzle for fryer protection,the nozzle must be positioned anywhere along or within the perimeter of the maximum hazard area and angled to the center. WITHIN SINGLE NOZZLE COVERAGE 36 IN. (91 cm) 36 IN.(91 cm) 77 IN. r,,MAXIMUM .� (43.2�) /--- I \\I , .,,, ....„,, . ...,....___ , _ . . f IN_(2.5 cm) ....,‘, „,...,,,„ �► 1 IN. 5 cm) Ii EXCEEDS SINGLE NOZZLE COVERAGE 38 IN. .a..� (96.5 cm) 18 IN. (46 cm) l I t \ / I 26 IN.(66 cm)_ i d MAXIMUM ] - ye' \ gI �/ I�\ t01N.(25 cm) � MINIMUM f �Y� f f N.(2.5 cm) IIIIE 1 IN.(2.5 cm) FIGURE 33 C FIGURE 32 • COVED RE 1 zos vEB b ,SC1t4' • SECTION IV — SYSTEM DESIGN -,I.S EC 3470 ULC CEx747 Page 4-20 REV.4 10-1-02 2-Row Griddle Protection(Continued) Option 2—Nozzle Perimeter Located (Continued) Medium Proximity Application: 20 in.to 30 in.(51 cm to 76 cm) above the cooking surface. The medium proximity application uses the 290 nozzle, Part No. 419342, . 1 The nozzle tip is stamped with 290 indicating this is a two-flow 1 , nozzle and must be counted as two flow numbers. One 290 nozzle will protect a maximum cooking area of 1440 sq. in.(9290 sq.cm)with a maximum dimension of 48 in.(122 cm). When using this nozzle for griddle protection, the nozzle must be positioned along the perimeter to 2 in. (5.1 cm) inside perimeter, and aimed at the center of the cooking surface. See Figure 41 and 42. _. 1,- -4 COOKING AREA ------2"- 1 1f----- - ----1 1 COOKING SURFACE I I •\ I I I/ I COOKING jf-r 1 I AREA 7 I --14 I-4— AIM POINT i t 290 NOZZLE LOCATED ALONG COOKING SURFACE EDGE • ANY SIDE OF GRIDDLE SURFACE WITHIN 0-2IN.(0-5 cm)OF • COOKING SURFACE EDGE. . NOZZLE MUST BE AIMED AT CEN- TER OF COOKING SURFACE. FIGURE 41 mom i 1 NOZZLE LOCATION ' -- I 1 1 0-2 IN.(0-5 cm) I I INSIDE PERIMETER 1 30IN. --4-I I.4.- OF COOKING SURFACE ft I (70 cm) '.., I I MAXIMUM //le1 HEIGHT:1°P TIP 4, I I tt °NFO27 I 1 / 1 I 201N.(51 an) 1 . I / i 1 MINIMUM I I /// I I "Eltrro I I 1 1 0F / i 1 N\0221E TIP I I 1 1 1 I i RECEI / "It) EDGE OF COOKING SURFACE FEB 0 2 201; FIGURE 42 Jefferson i County coma EnVirannlent.-1 1 SECTION IV — SYSTEM DESIGN - UL EX.3470 ULC CEx747 Page 4-16 REV.5 10-1-02 Range Protection 2-Flow Nozzle Low Proximity Application (2-Flow Nozzle): 15 in. to 20 in. COOKING LONGITUDINAL (38 cm to 51 cm)above the cooking surface. AREA —i' CENTERLINE The low proximity application requires two(2) 290 nozzles, Part No.419342. The nozzle tip is stamped with 290 indicating this is a two flow noz- a ,�, 1l zle and must be counted as two flow numbers. COOKING Two (2) 290 nozzles will protect a cooking area of 1008 sq. in. , , AREA (6503 sq.cm)with a maximum dimension of 36 in.(91 cm). Lr, El r4!J When using two of these nozzles for low proximity range protec- L "!! f tion, the nozzles must be positioned along the cooking surface 29G NOZZLE TIP perimeter to 1.5 in. (3.8 cm)inside the perimeter,and aimed at a -► LOCATION CENTER OF 45° angle along the longitudinal centerline of the range. See COOKING SURFACE •Figures 33 and 34. 290 NOZZLE TIP LOCATION *2 IN.(5 cm) 0-151N.(3.8 cm)IN FROM EDGE 000239 290 NOZZLE TIP OF COOKING SURFACE -4- LOCATION 0-1.51N. i (0-3.8 cm) IN FROM EDGE OF COOKING 45° COOKING SURFACE 45° AREA o00zno 20 IN. ilk 1 i All! 201N , (51 cm) I (51 cm) MAXIMUM I I MAXIMUM COOKING AREA 15 IN.(38 cm) I I '15 IN.(38 cm) MINIMUM , I MINIMUM 11 � r_ al,t/ 0 0 0 0 0 0 290 NOZZLE TIP /lr"—.."-". -.4 ~ - LOCATION CENTER OF \ COOKING SURFACE *2 IN.(5 cm) ► ZZLE TIP FIGURE 33 0-N5 IN.3.8 cm)OIN FROM EDGE 002276 OF COOKING SURFACE '' FIGURE 34 g. rF, RECEIVEL ¶EB 0 701'1. P SSQt) ( U(tt`1 Jeff er lE 18.20.180 . P'')impacts discernible beyond the property bound- library, or similar adult gati#g place, \ari2i f aries. operated in association with ie active (t) Not more than one cottage industry shall (ii) Child care facilitigs for the ex4sive be allowed in or on the same premises. use of employees of a business or-public facilii,9j5 (u) The proposed cottage industry shall shall also be allowed as an-aCEqssbry„t e of the ,�`` comply with the standards and requirements of the business or facility. Prior to initia A'tiq*" �' Jefferson County environmental health depart- an accessory use child day care center,th- .G1:, . r ment. must register with the county as specified in 1Y-/1/7- (5) Auto repair and service proposals are sub- section. ject to the following additional requirements: (e) No structural or decorative alteration is (a) The proposal shall submit a detailed allowed which would alter the residential character operating plan in compliance with the latest addi- of an existing residential structure used as a child tion of the Washington State Department of Ecol- day care center. ogy's Guide for Automotive Repair Shops (f) An off-street area shall be provided for identified as Publication No. 92-BR-16. vehicles to drop off and pick up children. (b) The proposal shall include an operating (2) Residential Care Facilities and Nursing plan which complies with the Department of Ecol- Homes. The following standards apply to all resi- ogy's SMM. The submittal shall include a storm- dential care facilities and nursing homes: water management plan in compliance with (a) The provider shall demonstrate compli- Chapter 18.30 JCC and include supplemental ance with state licensing requirements; information which addresses and complies with (b) Prior to operation, each provider must Volume IV-2.1 and 2.2 of the SMM. file a facility registration form with the administra- (c) The operation shall be limited to two tor.The provider shall identify the classification of stalls or bays for repair and servicing. the care facility as specified in state law and must (d) The cottage industry shall not store more demonstrate compliance with the applicable than three vehicles at any one time awaiting or requirements of this code as listed on the registra- departing for or from servicing`or repair. This tion form. [Ord. 8-06 § 1] excludes the vehicles being actively serviced in the facility. 18.20.182 Food and beverage stands. (e) A 50-foot buffer shall be maintained (1) Food and beverage stands are divided into from the structure housing the auto repair and ser- three separate classifications. A food and beverage vice to all adjacent property lines. [Ord. 8-06 § 1] stand must meet the specific standards for either a mobile,temporary,or permanent unit as well as the 18.20.180 Day care and residential care general requirements in this section. Each shall be facilities. required to adhere to the applicable requirements (1) Child Day Care Facilities. The following of the Jefferson County health department. standards apply to all child day care facilities: - -,.. (2) Mobile food units are defined as readily (a) All day care facilities shall demonstrate movable food service establishment. "Readily compliance with state licensing requirements. movable" means that the unit can be easily moved (b) Prior to initiating child care services, within an hour without major modification.Mobile each child care provider must file a child care reg- units may be walk-up or drive-through units and istration form with the administrator. The provider include carts that can be rolled around by hand, shall identify the classification of the day care self-propelled vehicles, or built on a mobile trailer rn facility as specified in state law, and must demon- unit frame.Mobile units are allowed without a per- state compliance with the applicable requirements mit; provided, that they meet all of the applicable I..., of this code as listed on the registration form. crite '= lis d in this section. (c) Equipment used in the day care opera- (a) obile units that fit the criteria listed in tions shall comply with all building setback WA •:-150V-0020 for conversion vendor units requirements for the land use district in which the require certification by Washington State L&I and facility is located. must have their insignia posted on the unit. Mobile (d) Day Care Facilities—Accessory Use. units that are moved by hand do not require an (i) A child day care center shall be con- insignia from L&I. sidered an accessory use if it is sited on the pre- (b) The operator of a mobile unit must sub- mises of a community service use,such as a private mit a planned itinerary of operating locations, or public school, grange, community center, approved servicing area(s), and written permission (Revised 8/06) 18-114.14 Jefferson Co Dept of Comm Dev WA - Online Payments Page 1 of 1 Jefferson County - �� E V.� ra.^a�,.ems �A`. y^>: <. � � d 3 FEB 1 2 2015 Step 1:Select Payments Step 2:Review and Submit Step 3:Confirmation and Receipt Step 3: Confirmation and Receipt coy 1.r!in ow �oP�r,EnT Result: Payment Authorized Confirmation Number: 16931430 Your payment has been authorized successfully and payment will be processed. Jefferson County Department of Community Development thanks you for your payment.For questions about your account,please call 360-379-4452 Thank you for using our bill payment services. Please save or print a copy of this receipt for record keeping purposes. My Bills Description Amount Due Commercial Applications payment of$253.50 on Parcel Number 942903605 $253.50 Subtotal: $253.50 Customer Information Convenience Fee: $7.50 First Name: kenneth Total Payment: $261.00 Last Name: kinnan Address Line 1: 26 Address Line 2: duckubush rd City: brinnon State: Washington Zip Code: 98320 Phone Number: 360-302-1655 Email Address: kennan23 @yahoo.com Payment Information Card Number: **""**'""*'003 Expiration Date: **/"* Print https://client.pointandpay.net/web/JeffersonCoDeptofCommDevWA 2/12/2015 Parcel Details Page 1 of 2 e erson ounty .- ££6 P. f---, .';:c. -Fes. - 4_ _ C . S Home : County Info a Departments Search Parcel Number: 942903605 SEARCH Parcel Number: 942903605 Printer Friendly Owner Mailing Address: GUNNING TRUSTEE JOHN GUNNING FAMILY TRUST 1210 F ST __ PORT TOWNSEND WA98368-5109 s FEB 1 2 2015 `°i Site Address: 10644 RHODY DR l I _—.1 PORT HADLOCK 98339 L_— Section: 3 School District:Chimacum (49) _-- rFT.OF CO'r' NITY DEVELQPMENT Qtr Section: SE1/4 Fire Dist: Chimacum (1) Township: 29N Tax Status: Taxable Range: 1W Tax Code: 0211 Planning area:Tri-Area (4) Sewer: Drainage: Bank: View 1: View 2: Zoning 1: Zoning 2: Zoning 3: Sub Division: 9429 - CHALMER'S 2ND Assessor's Land Use Code: 6000 - Commercial Banks Offices Servs Property Description: CHALMER'S 2ND ADDITION BLK 36 LOTS 13 THRU 17 W/PTN VAC ALLEY ADJ W/EASE V573/P921 REST/COVT #542991 Tax,A/V, Sales, Photos, and Permit Data Bldg Data Map Parcel Plats&Surveys Septic Monitoring Info iii,feri, Jefferson county "„ HOME I COUNTY INFO I DEPARTMENTS I SEARCH Best viewed with Microsoft Internet Explorer 6.0 or later Windows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel N0=942903605 2/12/2015 Begin Time: !d 1 ° End Time: ti *.% DEPARTMENT OF COMMUNITY DEVELOPMENT .r, 621 Sheridan Street, Port Townsend,WA 98368 { Tel:360.379.4450 I Fax:360.379.4451 Web:wv�w.co.Jefferson.wa.us/communitydeveiopment , r _ .t\ r r 1 Kt. . , E-mail:dcd@co.jefferson.wa.us 1 - ■ It I N GAO I ! . i 1 11I I, I Customer Assistance Intake Form Help us provide you the information you need by filling out this form. This is a public information form, the contents of this form is available to view by the public. • The first 15 minutes of staff time is free. Office Use Only • After the first 15 minutes, a minimum of one hour will be charged at the rate of $78.00 a hour with additional time over Receipt#: one hour billed in 15 minute increments. Check/CC#: • Please complete form and submit to the address or email Date Paid: above and a staff member will contact you. • Our goal is to respond within 14 calendar days of the request. Received By: NAME: .iii i1/1 / rbibla DATE:Cg/dA5 EMAIL ADDRESS: a / / ,g ° _ MAILING ADDRESS: ;-9 ' 4-7 I. LOC ' ((i/ --,_>1 e (i° ! jZ,,,i7, d' /f it- 1 4"- TELEPHONE: (HOME) ' ,e.; "'4 (- (6 '5— (CELL) .T1 PLEASE NOTE: Information and guidance provided through Customer Assistance is advisory only and is based on information provided by the customer. This is not intended to be an exhaustive review of all potential issues.Any discussion or information provided shall not bind or prohibit the County's future implementation or enforcement of all applicable laws and regulations. No statements or assurances made by County representatives shall in any way relieve the applicant of his or her duty to submit an application consistent with all relevant requirements of County, state and federal codes, laws, regulations. land use plans.and other re .ements. Your Sign att`tr :._ v A, Z 61.,C ! " f Monday, September 29, 2014 Map Output Page 1 of 1 ArcIMS HTML Viewer Ma 4 f 94294„30 :.T �! �!94294324 9429'13?CN 942903 r4 129(3;09 •,,'< 04290 illik ..t, �<nr 9a2943��s:1 s r — �r r'13,,f•*" •92903203842903504 �� d 84290354 a. ' ,� ��:_- 94290535 1 • 942903401 942903543; r�i a '942903508$4290354&942943517 9429038131 Legend ,04, 94 6OOO2&�` '" Selected Features . ti'e` ' 942903742 E 942903603. 3800025 JCRoads Lk �' fa Parcels H ,. rig . . 2033 Aerial Photos i .942903708 r HI a •943037115 � C3IN921 442943144 _ 94 .rrr�u a '1;a w r, t m 90 { 380001' Rp f/400U5 942903843 97129141802 a 942905841 o • vim cr41q a�F' <. > �' Asa 9183001E 978300148,,, @. - 97830010*, ,..14.., ' wry ' 978340041 978 i... 97s344s42r, f , ..s- k h � E 4;� 8344205 7830020(1' ` M-7 Rv- ' ''Je41 i 51203CamFxSetit G09783002N accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained • this map is limited by the method and accuracy of its collection. Mon Feb 02 11:59:52 2015 httn //xiccerver/cervlet/nnm Pori ecriman Rcriman9ServiceN2me=nvmanRrC`lientVercinn=4 n 7/7/x(115 Map Output Page 1 of 1 ArcIMS HTML Viewer Map sa2�a33oa 942 03202 942u�3^�a 9x2903` 0 942903'08 • - _..._a..: -- 942903'07 9429+_13'G3 942903203 3g29gg tlkq ¢ 50"023008 "•t 94290351' 942903:02 9.12?3350'. c _ is X12903401 9429035(73 ` 941903506 9A1iY�3x} 9429u35' 9429t?35t>fi r SR 118 9436°X2 7 a17e5St `" 942 }3605 Legend 9429X3502 = a�13500026 Selected Features 9.12903707 942903604 ''' X42903702. 942803603 ` 2 _ 9435tYe{i' Pa Roads ,.. , 35CGd724 � '1 Parcels-ti 912903608 fi Transitional Rural Zoning :'0429037*: at 942903703 542903605 '9429036f-6 < - � ° Ru�Residontia11:2 942903X175 ; 9436c:0023 94364Y)021 Rural RasAlani{ai tae lian, ' 37" s 943643022" Rur�Ras dentta11:2G , a4 RaA s arM Recnori�on 94250370' __S tiS 9+136/,)05315. ® Rur 1 Via center . .. 9A35S,+L016 . y ;i Cramoads«CC ,.�: Crossroads.CC • ) of _ 2g)38) 4 942903&3 w x12 9 03410 S1 x 73,5 C9l 433tY6sG04 0a 0n1d3 a Rd 1:, 00102304'3 r m ,''' r e II 979300603 905 S2A5{ .283006°1 `102 /83S06 4 3 /B3U}104 , 9183101 ' t o781E0s09 ; a,,w‘. -a Is St 975300206 , 978300203 ° .^- t1a7s:ru°205,,. *'-*rii:araf Ca�YtE Sa.,tas G4 97$3002(78 b _,y 978300503•-xa� FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Feb 02 115905 2015 httn://aisserver/servlet/com.esri.esriman.Fsriman7Servire.Name=nvman&ClientVercinn=4 0 ')/'/')(11 5 Donna Frostholm From: Donna Frostholm Sent: Wednesday, February 04, 2015 3:01 PM To: 'oscar40jl @gmail.com' Cc: Mina Kwansa Subject: CAM15-00053 - food and beverage stand Jim: Your food stand would need to comply with the temporary food and beverage stand requirements of JCC 18.20.182(3) if you are looking for a temporary use of the area. When you came in earlier this week, I did not notice that a temporary outdoor permit would be needed (see JCC 18.20.182(3) of the code section I gave you; also see JCC 18.20.380, which is available online,for information about temporary outdoor uses). The temporary use permit fee is$253.50 ($234.00 permit fee plus$19.50 case file scanning fee). Finally, if you think you may want this to be a permanent, you should review JCC 18.20.182(4) of the code section I gave you. Donna yrosthoCm .associate Tlanner/Wetland Specialist Jefferson County Department of Community Development 621 Sheridan Street Tort Townsend; Washington 98368 360-379-4466 dfrostholm@cojefferson.wa.us DCD is open from 9:00am—12:00pm and 1:00pm—4:30pm Monday through Thursday;DCD is closed on Friday. All emails sent to and from this address will automatically be archived by Jefferson County and emails may be subject to Public Disclosure under Chapter 42.56 RCW. 1