HomeMy WebLinkAboutMIS95-0049 Hood and Duct Dry Chemical - MIS Permit / Conditions - 1/27/1995 r
[( ;- MASON COUNTY
r Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M i S C E L- l._A N E a kJ�S P F 1-1 M I T FOR INSPECTIONS CALL 427-9670
M I S95-0049 PARCE l. :4201 8 1 200050 PLAT : D I V : 13LK t t o"I
JOB ADDRESS : W 7620 SHFLTON-MATLOCK RD SHEL.TON
APPLICANT : JACKIE GROVE 627-5458
OWNER : JACK 1 E GROVE 627-5458
LEGAL : TO 5 1V 1E EX 1.1 1111 FS 16421
PROJECT DESCRIPTION :
hood and duct dry chemical
PROJECT LOCATION :
PROJECT NOTES :
TYPE AMOUNT BY DATE RECEIPT
PRMT 1: 50 00 KS 01l27195 96
TOTAL : 50 .00 PWNER OR AGENT DATE:
�r
IIS 1111, rev, 911/1192
—.�---—._._.-- ———— ---------_.:.—
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT. Lies
date by date by date /-Z 6- 9 by Gn,Q m
PLUMBING OTHER -1-15-vs—
Groundwork
Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date Al,l✓ by date by
I
I
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �L�Oa•
PLEASE PRINT
141
_ _
#1 Owner J J c c� 6�&es Phone# dW-ol-Z N /
Site Address W- '7&01 "4M*ij- &161f (r -Fire District#
City SW6A/ St wo" Zip ''
Directions to Job Site S weI (W rAW 4v`ufli6'�- /d ka'yk'4( �6�y
Owner Mailing Address S Glut4' it) Qkz4zlC a&- A a
City St Zip
Lien/Title Holder 0
Address
City St Zip
#2 Contractor Name Contractor Reg #
Address MW Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic?--A�L Public Water Supply Well
Connect to Sewer System?--4 Name of System
(If residential, proof of potable water is required)
#4 Parcel No. - /C;;9, - '�D
Legal Description
#5 Building Square Footage: (existir y/proposed) F x (0
1st FI / I / _ 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / -carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building e4,,f/fi,)e Skeet ew , m C4ix�*w �aR Describe work
#7 Type of Job: New ✓ Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No.
# Bedrooms # Bathrooms Type of Heat
Purchase Price$
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
i
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: �k3l
10
Environmental Health:
Building Plan Review L--
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit �-0
Plan Check rj
Plumbing Fee
Mechanical Fee
oil —
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: �lL/ + TOTAL FEE IV
76Z.� �re+
"�'�+i.-�F7�V 7`�r,.;rf - �fif�G'JMA , V✓►4. T.`.'J�i��
t �
µGODL IN Ca r" wL2,
YY . it
►�4 ..�. 4- r�cr} —ego
P ,c 7t'c7,;
41 i IeEmOTE FJLL %
_ 1 P/ri S-6930
fir, G�.G.►= N '_"rr4
- O
—=-- -- -- O O C O
SG✓o'L
"ANSUL AUTCMAN" REGULATED RELEASE ASSEMBLY
(MECHANICAL)
-772�1'R1Z^AO72;: PILL..
AGENT TANK. ��. TO
RELEASE I I_ �1 `F�To M�U./a^IiGA-C�
MECHANISM
ReaULATUR
M I I
I
VI
R-102 RESTAURANT
FIRE SUPPRESSION
SYSTEM
PIVAM WORM&PULL STATOM SMOU APPL"rON
PtALVnao..
I �
wwa ra.a 4DOX /i;
vc
CAau
UMO ec.—gY
INOT}lTJW A AIYULI Loch but
mog"ROO
PULL
II
SNX STUN
ABgT2 ,
PULL
w I\ q
STATrAr ION MANOLS
MA? 'SC=T k,F,F
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I
�1 MASON COUNTY FIRE MARSHAL �, (C9
Mason County Bldg. III 426 W.Cedar JAN i 19Q5
P.O. Box 166 Shelton,Washington 98SU _
(206)427-9670
E.RAL SERVICES
CODE ENFORCEMENT FIRE 114SPECTIO GOV I STIGATION PUBLIC EDUCATION
PERMIT NO. m�sg�oy q
MASON COUNTY FIRE PROTECTION SYSTEM
PERMIT APPLICATION
NOTE; This application must be completed and accompanied by a
minimum of three (3) copies of plans, specifications and applicable
calculations per Mason County Fire Protection Standards and brought
to the office of the Mason County Fire Marshal.. This is not a
permit, and failure to submit all necessary information will cause
a delay and/or rejection of your submittal. When a permit has been
issued, you will be notified.
PLEASE PRINT
#] OWNER � G,ep VC PHONE
SITE ADDRESS FI E DIST.
� E
CITY L st"- CA1191% STATE ZIP
DIRECTIONS TO JOB SITE
i
OWNER MAILING ADDRESS
CITY S;4-�- rCAIL/ STATE Z I P
LIEN TITLE HOLDER�t� �,,-0� m . �. .�
ADDRESS sae, r3c;�sc s-
CITY vas rzJ.c/ 7- 77 =s'z Zn&�r
#2 CONTRACTOR l*"Soc j5nvLt CONTRACTOR REG # A�I:ee g-SfLf�L
ADDRESS f v7 S r EXP. DATE
CITY 1'7dM''} STATE ZIP
#3 PARCEL # 56 TRS N6l t'll� R.
LEGAL DESCRIPTION 6rjOC66
#4 BLDG. SQ. FT (EXISTING/PROPOSED)
IST FL lore / 2ND / 3RD /
BASEMENT / DECK - #BR #BATH
GARAGE / CARPORT / ENCL ATTIC: Y N
OTHER SQ FT
USE OF BUILDING
#5 DESCRIPTION OF WORK:
SPRINKLER: WET DRY STANDPIPE: WET DRY
AUTOMATIC FlpE ALARM CORRIDOR SMOKES
HOOD & DUCT 'DRY CHEMICAL WET CHEMICAL HALON
NEW SYSTEM MODIFICATION uNUM13ER OF NEW DEVICES
MONITORING STATION PHONE
Ln lT�
I
Y903 313
#6 DOES YOUR SUBMITTAL INCLUDEt
X. DIMENSIONS, SCALE, NORTH ARROW? YES NO
2 . FLOOR FLAN AND CROSS SECTIONAL ELEVATION? YES NO
3 . ALL CONCEALED SPACES (LABELED COMBUSTIBLE `
AND NON-COMBUSTIBLE) ? YES NO
4 . ALL AREAS ON OPPOSITE SIDE OF NEW WALLS? YES —
5 . CUT SHEETS OR REFERENCES FOR ALL NEW DEVICES? YES NO-
6 - LOCATION/DESCRIPTION OF ANY EXISTING DEVICES YES N0_
7 . BATTERY CALCULATIONS FOR FIRE ALARM SYSTEMS? YES NO`
8 . RYSER WIRI
/ N(3 DIAGRAM FOR FIRE ALARM 3 —
� Y3TEh1
s? YE
g , HYDRAULIC s Na
uLzc CA
LCULATIONS
IONS FOR SP
RINKLER SYSTEMS? YES—NO—
NOTE: WORK MAY PROCEED ONLY IN ACCORDANCE WITH A VALID FIRE
PROTECTION SYSTEM PERMIT ISSUED BY THE MASON COU
NTY FIRE
MARSHAL. A VALID PE RE
PERMIT AND AN APPR
OVED SET OF PLANS MUST BE
ON THE
JOB SITE DURING CONSTRUCTION AND MUST
R
UNTIL A FINAL INSPECTIONREMAIN THERE
IS DO
NE E 7 BY TFiE MASON COUNTY' FIRE
MAI2SH.AL. FAIL R U E TO OBTAIN A VALID PERMIT PRIOR TO WORKING ON
A-FIRE PROTECTION SYSTEM AND/OR FAILURE TO PROVIDE THESE PLANS
AND PERMIT FOR THE MASON COUNTY FIRE MARSHAL MAY RESULT IN A
CITATION AND FIRE.
x
OWNERS AFFIDAVIT
I certify that-. X am exempt from the requirpmonhs of. the Contrae-
torn Rcgiatration Law RCW 10 .27, and am aware of the Mason CUUTAty
ordinnnnn rarpii rPmAnt-s for whi.eh thin pormit iw iwwuod and that all
work will be done in conformance therewi
th. No h c angel will be
made wi
thout fi
rst obtainingapproval PP from the Mason Coun
ty Fir
e
Marshal . �'
OWNER DATE
Cd23T�C�'z'ORS `AFFIDAVIT' . .
I certify that I am a currently registered contractor in the State
of Waahingtou and I am aware of the ordinance requirements
regulating the work for which the permit is issued and all work
done will be in conformance therewith. No changes will g be made
without ffrst approval obtaining a
� pP 1 from the
Maa ou County Bire
Marshal .
BY = DATE / 1 7 _ �
A11SUL il•tuim-to2 f Ir1F surf m7nslorl RYSrEP.19 .
• FILE COPY IfrSrALLATIUrI UESIaN St1EET
DA1FS—
CUSTOMErl AUT110111ZED ANSUL DISTI OUIOrI
_F I_R E S A F E
11nME
_ a�tJ<C5 7— ?G�L1J J`/f��rY1�t/- /f%'.�TL!G��L�, 1017 5 4 t It Ave . E .
', SntEEr 9tnEEt
Tacoma , Wa . 904211
City.SrnrEBZip City.SIA]EAZ11, cont Llc . IIFIIlESFS 121 (17,
r-ILL IN ALL ArmiornIATE DATA UELOW AND CAMEFULLY SKETCII IIA7-Ant) LAYOUT oN IffstuF
SYSTEM
N10del(s) and serini numbers
Location ��r�4GT GYM /�ZQTj>
Number or nozzles and fail No. —�El� + 7�rV'79 �e-'q ]� �'-1p9�0`�� <57c t?e7
fluntber of delector(s) and degree tilling 3ew,9- � ` � .2=l�1>✓ r,��
Energy shut-olf devices — type nrtd size M,-4lfc¢il/7��4r
Location c:-,o h/C
Other accessory equtpntenl provided (mull slllion, electric switches, etc.) Ind Iocnlion
COOKING/VE1111LAIING EQUIPMENT
f lumber of duct(s) and size _ cf—1 -
Ilood size and plenum size
ki,lxinturtt ientperalure determined at detector location(s) All' -
Cooking Appliances and size of cooking sutlace. (f 101 E: List Ippllances from loll to riyitl Ind In(licate+. Ihose being
protected.)
2.
3. G.
COMMENTS
Wec_erLify Lhat Lhe materials and equipment in this
insLallation are assembled wilhin the scope and intent
qL L1)e N. F. 1' . A . /196 and 9174curre11L issue , and the current
111, listed installaLion manual for Lhe brand material used
herein . We cerLJ.fy that our firm currently holds factory
insLallation licenses for Lhe brand equipment used het:ein.
I� I
`"-�,'�• .'^H"��•-+tit��.i�k#.y�-13.M�«� .;a:r;rT�4.w'Mier*'+��"-;,ft..�t1e.�=s:+ya�fp•-r7^,+"lam-"r-"A-�t,dP, x.q.; {;: .. ,f < - _ ... s.
t •
KNIGHT FIRE PROTECTION i
A DIVISION OF KNIGHT FIRE SPRINKLER
6436 MULLEN ROAD SE
OLYMPIA, WA 98503
(206) 456-2162
FAX 456-2151
LICENSE NO. #KMGHFS 150LD
24 HOURS AA DAY"
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSURANCE AGENT INSPECTION DATE
A 4 s4smW
ADDRESS ADDRESS ANNUAL SEMI-ANTI.
74 2-0 w V/
CITY STATE IP PHONE NO. PHONE NO. TIME AM PM
e -/ov,_ 985-9+ 4 3Z-0"71 0.1 00
CONTACT LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
SYSTEMANUFACTURER 280° 350° 500
360° 450°ZS ° GAS /
M ELECTRIC
0 1 V/
MODEL HOOD/D CT FRYEIj. BROILER GRILL BURNERS HOT TOP OTHER
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? . . . . . . . . . . . . . 0 X
2. Is cylinder pressure gauge and/or weight at acceptable levels? . . . . . . . . . . . . . W ❑
3. Are all safety tamper seals and devices intact? . . . . . . . . . . . . . . . . . . . 9!�
4. Are there any visible signs that system has been fired or tampered with? . . . . . . . . . . 0 )Er5. Check hazards against nozzle layout? . . . . . . . . . . . . . . . . . . . . . . . 11 0
6. Are all nozzles positioned and angled properly? . . . . . . . . . . . . . . . . . . . 0 0
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? . . . . . . .
8. Checked action on self closing caps? . . . . . . . . . . . . . . . . . . . . . . . 0 0
9. Tested system actuation with terminal link for proper operation? . . . . . . . . . . . . . .
10. Tested system actuation with manual pull stations for proper operation: . . . . . . . . . . .
11.'All manual actuators are unobstructed and in path of egress? . . . . . . . . . . . . . . .
12. Tested system actuation with thermostat for proper operation? . . . . . . . . . . . . . . 0 0 tz
13. Tested gas valve and cable actuation for proper operation? . . . . . . . . . . . . . . . . .jir ❑ ❑
14. Tested micro switch actuation,and/or manual reset for proper operation? . . . . . . . . ❑ 0 JK
15. Verified all cooking appliances are operational? . . . . . . . . . . . . . . . . . . . . 0 ❑
16. Removed all cylinders from mounts and inspect? . . . . . . . . . . . . . . . . .
(Note any added maintenance needed:
17. Inspect all chemical agents for contamination? . . . . . . . . . . . . . . . . . . . O
18. Fuse links have been cleaned and/or replaced to the current year?. . . . . . . . . . . . . . Pk 0 0
19. Is the hood and duct free from grease accumulation?. . . . . . . . . . . . . . . . . . . 0
5(
20. Checked exhaust fan operation and proper air flow?. . . . . . . . . . . . . . . . . . . 0 0
21. Current service tag is on system and pull station?. . . . . . . . . . . . . . . . . . . . 0 0
22. All new tamper seals and devices are intact?. . . . . . . . . . . . . . . . . . . . 0 0
23. Proper hand portable extinguishers properly serviced and certified? . . . . . . . . . . . . . 0 0
24. Is customer currently under a service agreement? . . . . . . . . . . • . . . ❑ ❑ ❑
Problems Found: IVa✓` ✓`-' a
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA stand
and the anufacturer's O&M manual and was operated according to these procedures with results indicated above.
.CUSTONCM YELLOW-KNIGHf kQ PINK-AU MOU"HAVING JURISDIC ON WLL)•INSURANCE
SERVIC CIAN CUSTOMER'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"