Permit Information
Permit Information
| Is this application for a New or Existing Permit (Renewal)? | Existing | 
Existing Permit
| Facility Name | (O) FUKULALA SUSHI IZAKAYA | 
| Facility Contact Email Address | [email protected] | 
| Facility Contact Phone Number | 678-860-2698 | 
| Facility Contact Name | Liwen Ou | 
| Existing Facility Permit Number | 4859 | 
| Facility Mailing Address | 880 Woodstock Rd ste 100, Roswell, GA 30075, USA | 
| Facility Address | 880 Woodstock Rd ste 100, Roswell, GA 30075, USA | 
| SwiftComply Establishment Profile URL | https://fulton-county-ga.swiftcomply.com/city/establishments/4179 | 
| Has anything changed since last year? (Enter N/A or no if no changes to owner, systems, etc.) | No | 
Owner / Corporate Information
| Owner / Corporation Name | Skyline Woodstock | 
| Owner Contact Name | Liwen ou | 
| Owner Contact Telephone | --- | 
| Owner Address | --- | 
Certification
Certification
| Full Name | Liwen ou | 
| Certification | Yes | 
Verification & Permit Fee Calculation
Fee Calculation
| How many subsurface system (exterior) tanks does the facility have? | 1-5 ($250) | 
| How many Manual (interior) 10-100 pound units does the facility have? | 0 | 
| How many Automatic Grease Recovery 20-35 GPM units does the facility have? | 0 | 
| Is the payment for the current year permit considered late? (RENEWALS ONLY: If today's date is prior to May 31, 2024, the answer should be no. If today's date is after May 31, 2023 the answer should be yes) | Yes (25% late fee will apply) | 
| Please enter how many years permit has been unpaid in the past (please enter 0 for none) (RENEWALS ONLY): | 1 | 
| Notes |  |