HomeMy WebLinkAboutBRN2015-00018 - BRN Permit - 3/25/2015 Inspection Line (360)427-7262
PyON Colu, y MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 3k2
Mason County Bldg. III
426 W. Cedar St '
Y Shelton, WA 98584
1NSJ
BURN PERMIT BRN2015-00018
OWNER: MARY&TED BAILEY RECEIVED: 3/25/2015
CONTRACTOR: FASSIO TRUCKING & EXCAVATION 36089807286 LICENSE: FASSITE909MO EXP: 7/18/20, ISSUED: 3/25/2015
SITE ADDRESS:
EXPIRES:
PARCEL NUMBER: 322325050001
LEGAL DESCRIPTION: UNION HOOD CANAL LAND & IMP CO BILK: 50 LOTS 1-4, 41-49 &W 15' 5 VAC ALLEYADJ &
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
BURN AT 360 E. KUHN AVE, CORNER OF SEATTLE STAND KUHN AVE
BURN TYPE: FEES
Land Clearing Type By Date Amount Receipt
Burn Permit JBN 3/25/2015 $160.50 S2201500000000000234
Total $160.50
BRN2015-00018 Please refer to the following pages for conditions of this permit. Page 1 of 4
CASE NOTES FOR
BRN2015-00018
CONDITIONS FOR
BRN2015-00018
1) Per includes two (2) inspections maximum, additional inspections will require a $73.00 re-inspection fee.
X
2) App is must call 360.426.4441, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
X
11
3) Ap i must call 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning.
X
4) ValidA must be on-site while burning. Land clearing burn permits are valid 30-days from issuance.
X I I 7� -
5) A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void. After a burn ban has been implemented,
all must be extinguished immediately.
X
6) The following materials may not be burned: Garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard,
treated ood, construction /demolition debris, metal or any substance(other than natural vegetation)that normally releases toxic emissions, dense
sm a or obnoxious odors when burned.
X
7) All a ial must originate from the property on whichthe burning is to occur.
X
8) The 're ust not create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property.
X
9) The um pile size is twenty(20) feet in diameter, with a minimum ten (10) feet firebreak around each pile.
X
10) Eac it ust be at least one hundred (100) feet from any structure and atleast fifty (50) feet from standing timber.
X
BRN2015-00018 Please refer to the following pages for conditions of this permit. Page 2 of 4
1
11) Do nq burn if wind is blowing more than seven (7) MPH.
X i
12) Do b rn if wind is blowing from XX direction. (This will be indicated on the posted permit at the time of site inspection.) '
X
13) A mini um of one qualified operator is required to be in attendance at the fire while burning. A burn site/fire shall never be left unattended. MUST
PROV 24 HOUR FIRE WATCH.
X
14) On Site Water is required between April 15th and Oct. 15th. The pump truck or trailer must have 300 gallons of water loaded and 200 ft of hose. (Pump
mus apable of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.)
X
15) It is a isable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. Permitted individual is
respo ibl for any rekindling on the fire/burn site.
X
16) Provi a vator/dozer with a fire extinguisher at the site with a qualified operator.
X
17) Provid 24-hour fire watch.
X
18) The p rson in charge of the fire will be liable for the cost of suppression if the fire gets out of control or if becomes necessary to extinguish the fire as the
resr-
19) forcement action.
X
Acc u t be passable with 2 wheel drive vehicle.
X 7t�
20) Fire s completely extinguished within three (3) days after ignition.
X
21) After bu s complete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth.
X
22) Fan
X
23)
BRN2015-00018 Please refer to the following pages for conditions of this permit. Page 3 of 4
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.
Sign t e Date
OWNER - REPRESENTATIVE - WTwi
Print Name (Circle one to indicate)
BRN2015-00018 Please refer to the following pages for conditions of this permit. Page 4 of 4
W
z .CONCRETE MECHANICAL Oo
MANUFACTURED HOME o y
Date B y � r
Footings!Setbacks Gas Piping Ribbons M
o Interior Date By interior-Date By Date By _
o Exterior Date By Exterior-Date By Set-upic
O0 INSULATION
Point Load I isolated Footings Date By
BG I SLAB INSULATION --- -•
Date By Data By FIRE DEPARTMENT 90
Foundation walls Floors Date By __4
m
Date By Data By DECKS 0
FRAMING walls Date By
Date By Data By PROPANE TANKS
PLUMBING vauR Date By
Date By OTHER
Groundvoork Attic
Date By Date By Type:
Date 6y
D.W.)f DRYWALL Type.
Int Brace Wail Date By, W
Date By -
0) Date By FINAL INSPECTION z
water Line Fire SeparationCD
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m Date By Date By Date By
m CA
o Pass or Request Inspect. c
Type of Insp. Fail Date Date Dane By Comments o
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BR1\T2015-
MASON COUNTY BURN PERMIT APPLICATION
426 W CEDAR ST. • SHELTON WA 98584
SHELTON 360.427.9670 •BELFAIR 360.275.4467•ELMA 360.492.5269
APPLICANT INFORMATION: CONTRA�OR INFORMATION:
Owner C Owner r D--rhA u6I VJCA Lasr To 24?
Mailing Address , v 8 Mailing Address
City LA✓1 State LA��Zip City State 1AW Zip
Phone Cell Phone �r Phone 0 k--7 Ar%aer Phone
Lie 7t a Hol er Contractor Reg.# f N 913 i}t QOR M 0 Exp. /
E-mail address E-mail address
Drivers Lic.# DOB Drivers Lic.# 5sZ'? (j D.O.B. �/
T•�r
TAX PARCEL NUMBER ?�e ,�!� — S U" 12�;JU DO Sec. Twn. Rng. Fire District
SITE ADDRESS(please incl de street name,p=ber&city
Directions to the site /
L
Parcel within 200'of: Saltw Lake❑ River/Creek❑ Pond❑ Wetland❑ Seas0nalRqaoffo Stream❑
Slopes or Bluff 15% Ye42 NO W4L4ulter be cut and sold in parcel preparation?Yes LNO. REC I V D
Does Site require FPA or 6 yr.Moratorium:Y o Is site being converted or replanted:Y o
Reason For land Clearing
Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS: 1'
• Valid permit must be onsite while burning
• The following materials are prohibited and must not be burned: garbage, dead animals, asphalt, petroleum products, paints, rubber
products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural
vegetation)that releases toxic emissions, dense smoke,or obnoxious odors when burned
• All materials must originate from the property on which the burning is to occur.
• The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property.
• Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each pile.
• Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber.
• Do not bum if wind is blowing more than seven(7)miles per hour.DO NOT BURN IF WIND BLOWING FROM
• A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire watch.
• On Site Water is required for permits between April 15&and Oct. 15'h.A pump truck or trailer with 300 gallons of water loaded and
200 ft of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50 foot section of hose.)
• Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator.
• Fire must be completely extinguished within three(3)days after ignition
• Fan required
• Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,ext.262
• Applicant's must call 360.426.4441,EACH day to report burning activity.Last 3 numbers of permit required at time of call in.
• Applicants must call 360.586.1044(ORCCA)EACH day to report/request any air quality issues associated with burning.
• After the bum is complete make sure the fire has not burned into the earth by checking the fire location for hot spots.
• It is advisable to pump the entire content of the water tank onto the bum site to assure the fire is completely extinguished The
permitted individual is responsible for any rekindling on the fire/bum site.
• A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a bum ban
has been implemented,all fires must be extinguished immediately.
• Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee.(at current rate)
• Access must be passable with 2 wheel drive vehicle
OWNER/CONTRACTOR 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,owner's legal representative,or contractor.I further
declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the
permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this
implication or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work
,osed The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason
t local fire authorities access to the above described property and structure for review and inspection.The person in charge of
he liable for the cost of suppression if the fire gets out of control or if becomes necessary to extinguish the fire as the result of
action.
Date 2�
.e -In& ate owner/Auplicant/ReD esentative