11945 SW PACIFIC HIGHWAY STE 206 ADDRESS:
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WASHINGTON
COUNTY,
OREGON
r
May 3, 1994
r,
John Barinaga
PO Box 616
West Linn, Oregon 97068 �� q l�� �Oc�r_, �• �fr�_-),f �C.)l�
q 9 RE: Plan Review /
Push Cart
Celestial Bean - �La6 T►Srn� �'/""
Dezi- Mr. Barinaga:
The Washitivton County Department of Health and Human Services has obtained the
plans for ,your proposed pushcart. Please be aware that pushcarts must operate ou;' of a
lic;;nsed ,:ommissary. A commissary must be designated and approved prior to licensing.
We request that you fill out the enzlosed Commissary Memorandum of Agreement form
prior to licensing. The Memorandum of Agreement expires December 31 of each
calen6ar year.
All water used on the push,;art must come from an approved public water system. All
liquid wastes from the waste water retention tar.', must be properly disposed of in the
sanitary sewer.
Tl,c following is understood to be shown on the plans with necessary changes for
approval noted:
1) A menu was not submitted. Only foods prepared in a designate] licensed
commissary or from an approved source may be served from the pushc:art. A
pushcart may serve only 9ne Kg!p99ked potentially hazardous food with
unlimited garnishes and toppings not to exceed (3) potentially hazardous
garnishes or toppings without prepackaging and can serve other nonperishable
foods or beverages. Potentially hazardous food may not be prepared from a
raw to finished state on the pushcart.
Department of Health & Human Services
155 North First Averue
Hillsboro, Oregon 97124
WIG Nutrition Plan (503) 640-3555 Administration & Planning: (50a; 693-4402 TDD (5031.648-8601
Health Services (503) 648.0881 FAX: Clinic 693-4522/Administration 693-A490 Environmental Health (5013) 648_872,')
Page two
2) Self-serve foods, food on display or within the customer's reach, must be
protected by packaging or sneeze shields. Please see the enclosed NSI-
pamphlet for information on sneeze shield requirements.
3) You must be able to move the push cart from the kiosk struc'ure to the
commissary for servicing.
4) There must be at least four (4) of each multi-use utensil on the pushcart at Glc
beginning of each day for the serving, preparing or dispensing of all food
items. When utensils become soiled or contaminated, they must not be used
until they are properly cleaned at the designated approved Commissary. All
multi-utensils and removable equipment must be washed, rinsed and sanitized
at a designated licensed commissary at least daily.
5) Your pushcart may only provide single-serv;ce articles for use by the:
customer.
6) Your plans show a hanoaiuPI with hot and cold running water. Please also
provide dispensed soap and tewels for handwashing.
7) All openings to compartments where food, water or other beverages rr ight be
stored must be designed to effectively exclude; dust, dirt, other contaminants
and insects and rodents.
8) Separate storage must be provided for all cleaning supplies away from food or
food items.
9) All operations and/or equipment must be an integral part of the pushcart.
Auxiliary -torage must be limited to impervious, nonabsorbent covered
containers (;red in a such a manner as to preclude contamination or
infestations. Au,.iliary storage for the pushcart can not !reed 12 cubic flet.
i(,) All storage of food, drink utensils, equipment, etc. must be off the floor or
,,round
I i) All equipment must be easily removable to permit cleaning adjacent to other
equipment, unless it is sealed to the mobile unit in such a man aer as f,)
exclude spillage, dirt and insect entrance.
12) You have indicated that cart surfaces are formica.
13) Fuel supplies, tools, pumps, etc. must bE located Fa that they are sealed from
food service, storage and preparation areas.
14) All hot water and steam generating presizure vessels must be equipped with an
approved temperature and pressure relief valve constructed and installed in
compliance with the Orepon State Plumbing Code.
Page three
15) Dimensions of the fresh water, hot waczr and waste water retention tanks were
not submitted. THIS INFORMATION ML--T BE SUBMITTED FOR
REVi1tW The waste water tank must be at least equal in size to the total
w."tcr capacity.
t 6) The refrigerator and/or ice chests for the pushcart must be equipped with a
spirit stemmed thermometer that accurLtely indicates temperature.
17) A covered refuse receptacle must be provided at each location where the
pushcart operates.
17) The pushcart mu;t be clearly marked with the licensee name or a distinctive
identifying syribol. The lettering must be at least two inches in height and of
a color contiw-Qt ng with the background color. if a symbol is us:M, it must be
at least 12 inches in diameter or of an equivalent size. An accurate scale
drawing or photograph of the symt of must be filed with our Department.
18) All employees must wear clean outer garments and conform to a high degree
of personal cleanliness, gic%oming and hygienic practice while engaged in
preparing or transporting food and drink or washing and storing utensils and
equipment. All employees must have current Washington County food
Handler's Cards. For information on oto taining a foodhandlcr's card, please
call 640-3460.
19) The pushcart must be mobile and easily moveab:e by no more than two
persons. Permanent wiring or plumbing to service connections is prohibited.
20) The pushcart must be listed .,id labeled as a complete unit by an apprcved
electrical laboratory or it must have a third party inspection. For information
on third party inspections, please contact Chris Christensen with the State
Building Codes Division at 378-7133.
21) This pushcart must meet all the Oregon rules applying to mobiit; u,iits in the
Oregon Revised Statues, Chapter 624 arid the Oregon Administrative Rules,
Chapter 333.
22) The enclosed Commissary Memorandum of Agreement form must be
sui,mitted prior to licensing and operation. The Commissary Memo,ranOum of
Agreement form expires December 31 of each calendar year.
23) The commissary must meet all the rules applicable to commissary operation
including, but not limited to dishwashing; haridwashing, food preparation
storage and cleaning, mop washing, etc.
4'4) Commissary and pushcart inspections must be conducted prior to license
approval. To schedule inspections, please call Tim Bunnell at this office one
week prior to operation at 648-8722.
j
Page four
25) A license application and $210.00 license fee must be submitted prior to
opening.
Please submit requested revision for final plan approval.
Very truly yours,
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Toby Harris, R.S.
Environmental Health and Sanitation
TH:aat
Enc:
c: Tim Bunnell
Brad Roast, City of Tigard
Chris Christensen
e■�o
INgPECTION NOTICE
City of Tigard Building Mapartrimt
13125 SR Hall B1R1. Tigard, Oregon 97223
Inspection Line (Rec-O-.Phoney 639-4175 Business Phone: 639-41/71
Inapectiont___
Tooting plbg. Underrl.ab Mach. ougtj-in A�r sdwlk
hound. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer_ Framing -91dg• )
Poet/Beam Mec-h. Rain Drain Insulation --Plumb.
Plbg. Underfloor Water
/Line Gyp. Rd. -Mach.
Date toqueatadt, � _�L_� - Times —PM
�0 /1
di 1
Addrosat — j Permit ♦: U l f
Builders ——
TIDO FOLSOWING CORM.-TIONS ARE REpUTAEDt /1/ U v
Vf
Ynepector: � _ natet�Z—��� 93
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
t
CITE OF TIGA RD
CnYOFTWARD
e6CMUNMY DEVELOPMENT DEPARTMENT 00110WON BUILL)IN6 1=LR1111T
1311S SW HM11 Blvd P.O.Box 23397,TkpM,Onegm 97223(5031 W94176 r . . . . . . .
SIrE ADDREISS. . . : 11945 SW PACIFIC HWY
PHRCELc
SUBDIVISION. . . . , I- C)FFARBER T'RACT'S NO. I ZONING; C-6
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
_---__--.------------------._--------_
REISSUE: FLOOR 0 PEAS-- -- EXTERIOR vWLL CC)N51'RLJL'1' 1(JN—
C;LPcq9 OF WORK. :REP FIRST. . . . E t N r L: W
'T'YP'E OF' LIE-)E. . . -CONI GECOND. . . :-f Fitt? 1,E.G7
TYPE OF Loi\isT. *.31,4 THIRD. . . . sf IV: G.. F= W1
OCCUPANCY GRP. tB2 TOA Q1 5 f ROOF CDj\15'r:B FlftE RET -1 . Y'
OCCUPOWL"Y LOAD: BASUvIENT. Sf AREA SEP. RATED:
STOR. I [AT. : 14 ft UARAGE. . . S f OCCU GEP. WiTCD:
FASHT? 1\1 MEZZ?:N RECD SETBACKS— REGUIREI,---------_--------_—.__
FLOOR
,---------------------
FLUOR LOAD. . . . . psF LEFT: Ft RGHT. ft FIR '3PKL.I%l idlvIOK LET. . ,N
DWELi-1140 Ulq.'('i S: F.R NT f-t REAH.; f-t 1.11i ALk1q.W FiNDICV. ACC .' 'y
BEDR01S., B I--)T t Is D11P LORR:hl
VALUE. 1. 53 ,48
Remar-lis , Re—r-aof b1dW over Suites '05 -'1 Q12. C o n t.i ti ua t i c,ri c,r vi o r,i;
stat,ted i.-ndet, primary pet,ni i t. or Lot,
Owneri - --------------------------------------------------- PEES
MILT BROWN type amol.lnt bV date t,ecpt
11945 SW PACIFIC HIGHWPY PRIYJT s V10 Divi (113/i92, 93—c.3 7 6 ii:6
TIGARD OR 972E3 5PC r s 14. 75 Uhl 103/iW/93 9 2,—E3 7
Phone #-.
Lontt,actor,: ---------------------------------
THONAS DELANEY
335L2 SE DOYLE ROAD
us,rAcADA OR 971D23
Pl-it)yie #: 646--1156 K :x09. 73 TOTiiL
3b861
------- RE C-01 f�,P_J) INbPECTIONIE-)
This permit is issued subject to the regulations contained in the Raaf na.tIng lriEp
Tigard Municipal Cuda, State of Ore. Specialty Codes and all other Final Insper-tic)r)
applicable laws. All work will be acne in accordance with
approved plans. This permit will expire if work is not Started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Pet,mittep 5ic1nati-tt-e :
Is!-,1_ted By :
Call fcit- inv_q)ection CZs?-4175
i
CITY OF
BUILDING PERMIT APPLICATION TIGARC� DATE �° 0 9 8 t)
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE '.'v,JRK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHorJE
OWNER ADDRESS 706 Tigard Pia=a BUILDER PHONE
ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL []FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGEOS,AB ❑FENCE
QBOND ❑MOVING ❑CONDITIONAL l,3E ❑DESIGN REVIEW ❑COUNCIL APPROVED OSIONS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE— PLAN CHECK Bv HEAT _
wall Sign - r F og,
_ (Age
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTME + SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
--- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plar. ;heck REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY !',GREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY B'JSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, •'LUMBING AND HEATING.
Total
By
—� �--- APf PNT OR AGENT
Approved Receipt Receipt No --
ADDRESS –'NONE
DATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
[Permit
ontractor
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Fixture
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HEATING
Contractor
Permit No.
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Rough-in
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(Rain Drain) Final
Sidewalk
Curb&Street Final
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dFIEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY - — —
LTndscaping
Zoning Final
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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE 19_ N� 0391
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
#tc''aC'�o
OWNER iYt a3i ADDRESS BUILDER PHONE
ENGINEER
Rull DFg or. aon '-tuof Ing Co. ARCHITECT _ DESIGNER
STRUCTURE C_1' 'W ❑REMODEL ❑ADDITION ❑REPAIR ❑HENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE I ",OMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DCSIGN REVIEW ❑COUNCIL APPROVED [:]SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT_
t'QQ t'
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
FBUILDING DEPARTMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJEC- TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL BE DONE IN ACC 7RDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICAELE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— --- 1ESTRICTIVE COVENANTS. COlitRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPAr..ATE PERMITS R60UIRED FOR SEWER, PLUMBING AND HEATING.
Total
By APPLICANT OR AGENT
Approved Receipt No.
ADDRESS
DATE INSP. TYPE INSPE.TION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rou h•in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
_ Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
_ Landscaping
7 1 '� Zoning Final
CITY OF TIGARD
APPLICATION FOR "'IGN PERMIT
OWNER PT-".RfviTT Uri s _11KTR _:I
b,DDRESS -VALUL PERMIT EEE"4
TEL,
MANUFA TUEFR
ADDRESS
7
-ILL" NO
jNqPF('TTQNq REQUIRED
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SIGNATURE DE PER TTTFP
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APPROVED C111EF BUILDING OFFICIAL
By
Address01; �• ��'n �� Permit No. _--
Petnit charge
LZ?
Owner i, .v �, -�'-L����-- Connection fee_ -
vet I/ 5 Paid by_______--.
Type of BuildingDate connected
Service Rate Inspection fee
Contractor Paid by Date
Size of connection „ - Assessment ---Paid
4 f
I VAL
71 W
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