HomeMy WebLinkAboutFIR2016-00050 - FIR Permit / Conditions - 11/28/2016 60)427-
262
r 0$oN �aUN,F MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT InspPhonection
Line
i e(3670 ext7352
Mason County
=t 615 W Alder Street `
'• Shelton, WA 98584
FIRE PROTECTION PERMIT FIR2016-00050
APPLICANT: WOLVERINE WEST, LLC RECEIVED: 11/10/2016
CONTRACTOR: LICENSE: EXP: ISSUED: 11/28/2016
SITE ADDRESS: 10 EALDERBROOK DR UNION EXPIRES: 5/28/2017
PARCEL NUMBER: 322335000014
LEGAL DESCRIPTION: SUNNY BEACH PCL 1 OF BLA#04-58
PROJECT DESCRIPTION: FIREWORKS DISPLAY FOR BLACK FRIDAY NOV 25, 2016 AT THE ALDERBROOK RESORT (FIRED ON HOOD CANAL)
GENERAL INFORMATION System Information
Type of Use: DIS
Fire District: 6 Sprinkler Heads: Audible Switches: Pull Stations:
Flow Switches: Visual Devices: Door Releases:
Hood& Duct?: N Pressure Switches:: Smoke Detectors: Duct Detectors:
Dry Chemical?: N Zones: Heat Detectors:
Wet Chemical?: N
Sprinkler?: N
Standpipe?: N SQUARE FOOTAGE FEES
Monitoring Company: First Floor: Type Amount Due Amount Paid
Monitoring Phone No.:() - Second Floor: Fireworks Display Permit $250.00 $250.00
Auto Fire Alarm?: Third Floor;:
Total: $250.00 $250.00
FIR2016-00050 Please refer to the following pages for conditions of this permit. Page 1 of 4
i
CASE NOTES
FIR2016-00050
CONDITIONS FOR
FIR2016-00050
OWNER/ BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by
signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature Date
OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
FIR2016-00050 Please refer to the following pages for conditions of this permit. Page 2 of 4