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HomeMy WebLinkAboutFIR2013-00037 - FIR Permit / Conditions - 11/13/2013 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line (360)427-7262 Mason County Bldg. 3 426 W. Cedar P.O. Box 279 Phone: (360)427-9670, ext. 352 Shelton, WA 98584 i� FIRE PROTECTION PERMIT FIR2013-00037 APPLICANT: WOLVERINE WEST, LLC RECEIVED: 10/30/2013 CONTRACTOR: LICENSE: EXP: ISSUED: 11/13/2013 SITE ADDRESS: 10 EALDERBROOK DR UNION EXPIRES: 5/13/2014 PARCEL NUMBER: 322335000014 LEGAL DESCRIPTION: SUNNY BEACH PCL 1 OF BLA#04-58 PROJECT DESCRIPTION: FIREWORKS DISPLAY NOVEMBER 29 CHRISTMAS TREE LIGHTING EVENT OJ S , GENERAL INFORMATION Syst em Information Type of Use: DIS Sprinkler Heads: Audible Switches: Pull Stations: Fire District: 6 Flow Switches: Visual Devices: Door Releases: Hood& Duct?: Pressure Switches:: Smoke Detectors: Duct Detectors: Dry Chemical?: Zones: Heat Detectors: Wet Chemical?: Sprinkler?: Standpipe?: 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 FIR2013-00037 Please refer to the following pages for conditions of this permit. Page 1 of 5 i CASE NOTES FIR2013-00037 CONDITIONS FOR FIR2013-00037 f f per 1 inch of mortar diameter is required. Maximum mortar size that can be discharged from the dock/float area is 4 inch. 1.) Aclear zone o 70 feet p q g X RFH Per section 3308.4 of the 2012 International Fire code. Clearance: Spectators, spectator parking areas, and dwelling, building or structures shall not be located within the display area. Exception:2 . This provision shall not apply to un-occupied dwellings, buildings and structures with the approval of the building owner and the fire code offical . It shall be the responsiblity of the display holder to obtain approval from the property owners prior to the fireworks display. X RFH Per section 3308.6 of the 2012 International Fire code. Mortars for firing fireworks shells shall be installed in accordance with NFPA 1123 and shall be postioned so that shells are propelled away from spectators and over the fall out area. Under no circumstances shall mortars be angled toward the spectators viewing area. Prior to placement, mortars shall be inspected for defects, such as dents, bent ends, damaged interiors and damaged plugs. Defective mortars shall not be used. X RFH Post fireworks display, the firing crew shall conduct an inspection of the fall out area for the purpose of locating unexploded aerial shells or live components. This inspection shall be conducted before the public access to the site shall be allowed. Where fireworks are displayed at night and it is not possible to inspect the site thoroughly, the operator or designated asistant shall inspect the entire site at firsrt light.A report identifying any shells that failed to ignite in, or discharge from, a mortar or fail to function over the fallout area or otherwise malfunction, shall be filed with the fire code offical. X RFH There shall be a minimum of 2 approved water filled pressurized fire extinguishers. X RFH FIR2013-00037 Please refer to the following pages for conditions of this permit. Page 2 of 5 QWNER/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. Digitally signed 11/21/13 Signature by Rudi myDate Date:2013.11.21 Rodney F. Hash 14:46:50-08'00' OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) FIR2013-00037 Please refer to the following pages for conditions of this permit. Page 3 of 6 -n [ CONCRETE MECHANICAL MANUFACTURED HOME p p Date By r Footings /Setbacks Gas Piping Ribbons rCTI CInterior Date By interior-Date By Date By X OC Exterior Date By Exterior-Date By set-up z V Point load!Isolated Footings INSULATION Dane By BG 1 SLAB INSULATION rn Date By Data By FIRE DEPARTMENT N Foundation Wails Floors Date By -� Date By Data By DECKS r FRAMING wails Date By n Date By Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Date B Date By Type: y Date By D.W.b DRYWALL Type Date Int.Brace Wall Date By 6y y Date By FINAL INSPECTION N A Water Line Fire Separation Co m Date By Date By Date By W O 0 Pass or Request Inspect. o Type of Insp. Fail Date Date Done By Comments o ass 11-22- /3 0 t✓ a d m c� N O n O 3 a 0 N O (A fD N f0 lD A O (A �6oN ooU��F MASON COUNTY (360)427-9670 Shelton ext.352 DEPARTMENT OF COMMUNITY DEVELOPMENT (360) 275-4467 Belfair ext. 352 y BUILDING. PLANNING• FIRE MARSHAL (360)482-5269 Elma ext. 352 Mason County Bldg. III, 426 West Cedar Street 7854 PO Box 279, Shelton, WA 98584 www.co.mason.wa.us FIR20 - OOD311 Mason County Fireworks Permit Application Incomplete applications will not be accepted A permit for retail sales or public display of fireworks is required. A completed application with required documentation and fees shall be submitted for Fire Marshal review. A permit will be issued upon satisfactory site inspection by the Fire Marshal. Applicant Information: X Owner: r l� Mailing Address: C City: State'.Zip: t3 Phone #: Qg17 Email: Sponsor Information: Name: Address: IL City: O LAA, State: Zip: Phone #: Email: Washington State Fireworks License Information (Copy Required): License Number: Date of Issuance ❑ Pyrotechnic Operator License ❑ Fireworks Stand License Bond or Certificate of Insurance (Copy of Certificate/Bond Required): Provider: Insured: Certified Holder: . Location of Stand/Display: ' ,S*te Address: n 29 - G tions to Site: arcel Number: (twelve digit number 3 Legal Property Owner **Please see reverse side to complete your application** IACommunity DevelopmentTIRE MARSHALTireworks Permit application.doc I IWO The following pertinent information MUST be provided on the site diagram below Location and Setback distances from the back, sides and front of retail sales stands or designated display areas to: Fire Hydrants Property Lines Mortar separation distance Combustibles Parking Designated landing area Fire Lanes Public Roads and Right of Ways Trees/Brush Private Roads and Right of Ways Utilities Landmarks uQ -P, ?e,o W+IA Lj-- Vi 1a g ,JIG N`N- , �3 tP•a�cX-`-i�� Applicants Affidavit I certify that the information provided herein is accurate and that compliance with all County, State and Federal laws pertaining to the sales or discharge of fireworks shall be maintain Signed Date (:\Community DevelopmentTIRE MARSHALTireworks Permit application.doc t MASON COUNTY (360)427-9670 Shelton ext.352 g°N CO DEPARTMENT OF COMMUNITY DEVELOPMENT (360) 275-4467 Belfair ext. 352 �A TA BUILDING • PLANNING • FIRE MARSHAL (360)482-5269 Elma ext. 352 -3 Mason County Bldg. III, 426 West Cedar Street 1854 PO Box 279, Shelton, WA 98584 www.co.mason.wa.us STANDARDS FOR THE OPERATION OF RETAIL FIREWORKS STANDS SALES: WAC 212-17-21505 Retailers of fireworks—General provisions. • Fireworks may be sold from 12:00 noon to 11:00 p.m. on June 28 through 9:00 p.m. on July 5. Fireworks may not be sold between the hours of 11:00 p.m. and 9:00 a.m. from June 28 through July 3. Fireworks may not be sold from 12:00 midnight on July 4 through 9:00 a.m. on July 5. • Fireworks may be sold from 12:00 noon to 11:00 p.m. on each day from the 27th of December through the 31 st of December of each year. • Licensees shall familiarize all persons working in a retail fireworks stand with the provisions of these rules. • Failure to comply at any time with the provisions of this rule or any other applicable regulation shall constitute a violation of chapter 70.77 RCW and may result in the temporary suspension or immediate revocation of the license or permit, closure of the fireworks sales or storage structure, the seizure and/or forfeiture of some or all of the fireworks, and other criminal penalties as specified by law. APPROVED FIREWORKS: • Only Division 1 AG consumer fireworks, obtained from state-licensed wholesalers, not otherwise prohibited by chapter 70.77 RCW or local ordinance, and holiday related products incidental but related to these products, may be sold in retail fireworks stands. FIREWORKS STAND LOCATIONS: WAC 212-17-21509 Retailers of fireworks-Location. (1)Activities or uses subject to this rule shall not be limited in location except where such activities or uses are prohibited or controlled by local development regulation, traffic safety or road construction standards. (2) Temporary retail fireworks stands shall not be located more than one hundred fifty feet from a private way, fire department access road, public road, street or highway as measured by an approved route around the exterior of the stand. The minimum requirements for a private way IACommunity DevelopmentTIRE MARSHALTireworks Permit application.doc shall be determined by the local authority having jurisdiction, but shall not exceed the requirements of locally adopted street, road and access standards. (3) Any two retail fireworks stands shall be at least one hundred feet apart or shall be separated by a road, street or highway not less than thirty feet in width. (4) Retail fireworks stands shall be located as required by Table 212-17-21509 in this section. The minimum required area surrounding the stand shall be marked or flagged, except that flagging and marking shall not block a sidewalk or pedestrian pathway. Flagging need not exceed twenty feet in any direction. Retail Fireworks Stands - Minimum Clearances MOTOR MOTOR VEHICLE VEHICLE TRAFFIC TRAFFIC Combustibl Property Parki PUBLIC PRIVATE Buildings es Line ng ROAD* ROAD* BACK OF STAND 20 FT. 20 FT. 5 FT. 20 20 FT. 5 FT. FT. SIDE OF STAND 20 FT. 20 FT. 5 FT. 20 20 FT. 5 FT. FT. FRONT OF STAND 40 FT. 40 FT. 20 FT. 20 20 FT. 20 FT. FT. 20 FT.** 20 FT.** NOTE: Clearance distances are not cumulative *Measured from the outer edge of the nearest traffic lane. **If stand is equipped with 135 fusible links which will automatically close all sales doors in case of fire,or is equipped with a wire-mesh screen with openings of not more than one inch which covers not less than 90%of all sales openings. (5) Retail fireworks stands shall not be located closer than one hundred feet from any motor vehicle dispensing station, retail propane dispensing station, flammable liquid storage, or combustible liquid storage. Retail fireworks stands shall not be located closer than three hundred feet from any bulk storage of flammable or combustible liquid or gas, including bulk plant dispensing areas. EXCEPTION: 1.Fuel for generators as allowed by WAC 212-17-21513(4). 2.Fuel within the tanks of motor vehicles. SURROUNDING AREA AROUND FIREWORKS STANDS: WAC 212-17-21511 Retailers of fireworks-Area around the retail firework stand. (1) The minimum areas around the retail fireworks stand specified in WAC 212-17-21509 shall be kept free of accumulation of dry grass, dry brush and combustible debris. No parking shall be permitted within this minimum area. I:\Community Development\FIRE MARSHAL\Fireworks Permit application.doc (2)No motor vehicle or trailer may be parked within twenty feet of a retail fireworks stand except when delivering, loading or unloading fireworks. (3)Fireworks shall not be discharged within one hundred feet of a retail fireworks stand. Signs reading "NO FIREWORKS DISCHARGE WITHIN 100 FEET" in letters at least two inches high,with a principal stroke of not less than one-half inch, on contrasting background, shall be conspicuously posted on all four sides of the stand. (4)No smoking shall be allowed within the retail fireworks stand or within the minimum flagged off area. Signs reading "NO SMOKING WITHIN 20 FEET" in letters at least two inches high, with principal stroke of not less than one-half inch, on a contrasting background, shall be conspicuously posted on all four sides of the stand. ELECTRICAL SUPPLY & USAGE: WAC 212-17-21513 Retailers of fireworks-Stand use and construction. (1)Fireworks may be sold from: (a)A permanent structure which meets provisions of WAC 212-17-21505(3). (b)Temporary, stable structures made from wood, metal, fiberglass or other material. Any temporary fireworks retail stand greater than four hundred square feet shall meet the requirements of a permanent structure, except tents or canopies as defined in the International Fire Code retail stand greater than four hundred square feet shall meet the requirements of a permanent structure, (c) Tents, canopies, or structures utilizing temporary membrane material. All tents, canopies or Temporary membrane materials structures shall be made from fire retardant material or treated with a fire retardant as identified in the International Fire Code. Any tent, canopy or temporary membrane material structure falling within the scope of the International Fire Code shall comply with those requirements. When those requirements are in conflict with other provisions of these rules,the more restrictive provisions shall apply. (2) Battery powered equipment, electrical equipment and electrical cords which are used in conjunction with a retail fireworks stand or a temporary storage structure or location must be listed by a recognized laboratory and used in accordance with that listing. If electrical power is supplied by an extension cord, the size of the cord, the length of the cord and the amperage and the voltage supplied shall be in compliance with the requirements of the National Electrical Code, current edition. The cord shall be protected as necessary from "drive-over" and other physical damage.No additional permits from a city or county or state official having jurisdiction shall be required for these temporary uses except as specified in subsection (5)of this section. (3) All heating units shall be listed by a recognized testing laboratory and shall be used in accordance with the listing. Heating sources shall have "tip-over" and temperature overheat protection. All heating devices shall have sealed type elements (i.e., oil filled or water filled radiator type). Open flame heating devices are prohibited. (4) Generators which use combustible fuel and which are at least twenty feet from the retail fireworks stand or the temporary fireworks storage structure shall be allowed. Generator fuel shall be limited to not more than five gallons and stored at least twenty feet from all stands. (5) Compliance with the National Electrical Code, current edition, shall be required for all new, permanent electrical installations, including temporary power drops, subject to possible permit fees. (6)Retail sales of fireworks and other products which are holiday related shall be from buildings used for no other purpose. I:\Community Development\FIRE MARSHAL\Fireworks Permit application.doc 3TORAGE ASSOCIATED WITH RETAIL FIREWORKS: WAC 212-17-21517 Retailers of fireworks—Temporary fireworks storage associated with the retail fireworks stand operation. (1)Temporary fireworks storage is not permanent fireworks storage. Temporary fireworks storage is defined as storage associated with retail fireworks sales and may only be from June 13 through July 31 and from December 12 through January 10 of the following year. Permanent fireworks storage is associated with retail or wholesale fireworks activities when the period of time of storage is other than, or longer than that specified for temporary storage. Temporary fireworks storage shall be in accordance with this section. Permanent fireworks storage is subject to the International Fire Code and the and local ordinances. (2) Delivery of fireworks to a location, or storage of fireworks in a facility, not authorized by the license and permit is prohibited. If the approved storage location is outside the jurisdiction issuing the permit,the authority issuing the permit shall notify the appropriate authorities of the jurisdiction in which the storage is to be located. (3)A temporary fireworks storage facility or a temporary fireworks storage location shall be authorized as a part of a license and permit if it meets the requirements specified herein. (4)No open flames nor any type of open flame equipment shall be allowed in any temporary fireworks storage structure. (5) Storage of fireworks authorized by a retail license and permit is legal only during the periods specified in this section. (6) Fireworks may be stored: (a) In a locked or secured retail fireworks stand; or (b) In a locked or secured truck, container,trailer, other vehicle or anything similar which is not less than twenty feet from the retail fireworks stand during hours of retail sales; or (c) In a locked or secured truck, container,trailer, other vehicle or anything similar which is not less than twenty feet from an inhabited building where the term "inhabited building" is defined as in the International Fire Code; or (d) In a magazine which meets the minimum standards of Type 4 as prescribed by the International Fire Code, and which is not less than ten feet from an inhabited building where the term "inhabited building" is defined as in the International Fire Code; or (e) In a locked or secured metal or wooden garage, shed, barn or other accessory building, or anything similar which is not less than: 20 feet from an inhabited building for storage of fireworks for one or two retail stands; or 30 feet from an inhabited building for storage of fireworks for three or more stands. The term "inhabited building" is defined as in the International Fire Code. (7)The local authority having jurisdiction may reduce the minimum separation requirements of this section provided that safety of life and property is not diminished. (8)No cooking is permitted in a retail fireworks stand or in a temporary fireworks storage structure. (9)Temporary fireworks storage structures may be inspected prior to use and other inspections may occur on other days as warranted. There shall be no additional charge for all such inspections. IACommunity DevelopmentTIRE MARSHAUFireworks Permit application.doc t WAC 212-17-21519 Retailers of fireworks—Cleanup. (1)At the end of the legal selling period, all fireworks must remain in the retail fireworks stand,temporary storage location authorized by the retail permit or another location approved by the local authority having jurisdiction or his or her designee until returned to the suppliers from which they were obtained, or until transferred to an approved location. (2) Cities and counties may require a clean-up bond, not to exceed five hundred dollars, as a condition of the permit,to ensure the removal of all structures and debris from the site. (3) In order to obtain return of a clean-up bond, cleanup of debris associated with the retail fireworks activity and the removal of all temporary structures authorized by the license and permit shall be completed no later than 11:59 p.m., July 15 for the Fourth of July selling period or no later than 11:59 p.m., January 10 for the New Year's selling season. (4) Failure of the licensee to comply with subsection(3) of this section shall constitute forfeiture of the clean-up bond and the licensee shall be liable for any clean-up costs incurred by the city or county which exceed the amount of the bond. 1ACommunity DevelopmentVIRE MARSHALTireworks Permit application.doc PART I •� APPLICATION DATE OF APPLICATION FOR PUBLIC FIREWORKS DISPLAY PERMIT 11/6/13 PI TO: Governingbodyof city,town,or countyin which display is to be conducted. NAME ADDRESS PHONE Wolverine West Fireworks PO Box 99095 - Seattle, WA 98139 206.459.0917 SPONSOR ADDRESS PHONE Alderbrook Resort & Spa 7101 E Hwy 106, Union, WA 98592 360.898.5529 PYROTECHNIC OPERATOR NAME ADDRESS LICENSE# Chad Beebe 11210 Saskatoon Ln SE, Olympia WA 98508 P-04245 NAME OF ASSISTANTS: at least one required) NAME ADDRESS AGE Aaron Webb 800 Yauger Way SW E-208, Olympia WA 98502 40 NAME ADDRESS AGE EXACT LOCATION OF PROPOSED DISPLAY LOCATION Alderbrook Resort & Spa -7101 E Hwy 106, Union, WA 98592 DATE TIME 11/29/13 5:30pm NUMBER AND KINDS OF FIREWORKS TO BE DISPLAYED (24) Multi-Shot Cakes, (20) 30mm comets & up to (200) 1.75" Shells MANNER&PLACE OF STORAGE PRIOR TO DISPLAY Subject to approval of Local Fire Authority) In our approved magazines , SIGNATUIRE OF APPLICANT FINANCIAL_RESPONSIBitaTY BONDING OR INSURANCE COMPANY (Mark One) Professional Program Insurance Brokerage © Bond or certificate of insurance attached ADDRESS ❑ Bond or certificate of insurance on file with State Fire Marshal 371 Bel Marin Keys Blvd. Ste. 220 Bond or certificate of insurance shall provide minimum coverage of Novato, CA 94949 $50,000/$1,000,000 bodily injury liability for each person and event, j respectively,and$25,000 property damage PART II PERMIT PERMIT# DATE: In accordance with the provisions of RCW 70.77 and applicable local ordinances,this permit is granted to conduct a fireworks display as per the above application. NAME: (Full name of person,firm,or corporation granted permit) RESTRICTIONS: Permit not valid without verification of (Signature of Official granting permit) the appropriate State Fireworks License (Title) LICENSE NUMBER: (Instructions on reverse side) 3000-420-050(R 02/05) Distribution: WHITE(A): Local Fire Authority; YELLOW(B): Permitee Certificate of Insurance 2254 Issue Date: 11/1/2013 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF Professional Program Insurance Brokerage INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE 371 Bel Marin Keys Blvd., Suite#220 CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT Novato California 94949 AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED INSURER A: Underwriter's at Lloyd's, London Wolverine Fireworks Display, Inc. INSURER B: 205 W. Seidlers Road Kawkawlin, MI 48631 INSURER C: INSURER D: COVERAGES: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE FOR THE PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(DD/MM/YY) DATE(DD/MM/YY) GENERAL LIABILITY PY/13-0008 2/1/2013 2/1/2014 EACH ACCIDENT $5,000,000 A CLAIMS MADE MEDICAL EXP(any one person) FIRE LEGAL LIABILITY $50,000 GENERAL AGGREGATE $5,000,000 PRODUCTS-COMP/OPS AGG DESCRIPTION OF OPERATIONS/LOCATIONSNEH ICLES/EXCLU SION S ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is additional insured as respects the following: Date(s)of Display: 11/29/2013 Location: 7101 E State Highway 106 Union,WA 98592 Additional Insured: Alderbrook Resort&Spa, Mason County&its employees ATIMA Rain Date(s): 11/29/2013 Type of Display: Aerial CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXIPIRATION DATE THEREOF,THE ISSUING INSURERE WILL ENDEAVOR TO MAIL 10 DAYS Alderbrook Resort&Spa WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 7101 E State Highway 1 O6 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Union,WA 98592 AUTHORIZED REPRESENTATIVE �?i,T'NI ?�ar+{P ,T, ;a� �s r�r a*rr M7• §� `;1 i sk*� s g r+° Washington State Patrol 14611 Fire Protection Ron** . Office Of The State Fire Marshal VVashinton Mate Fireworks License Wholesaler License Wholesaler: Wolverine West, L. L. C. Post Office Box 99095 Seattle,WA 981390095 Detach this wallet card taxi carry with you for verification of cactifiication. In-State Representative: Rodney F. Hash � Washington State Parrot 14 611 I Fire Protection Human Phone Number: (20b)459-0917 O®ce ofThr State Flee Marshal y4Jholesaler: W f st,L.L. C. I �{ Date of issue Expiration Date License Number I TypeLicense Number: I Tone of License: �;. January 24,2013 January 31, 2014 C-04138 j Phone Number: I Expiration Date: J 4 I JAI I 3000-420-012(R 9/05) tare Fire t attue —Licens&Signature Washington State Patrol 4 0 Fire Protection Bureau Office Of The State Fire Marshal Wa hip ton tate Fireworks Licen a Importer License Importer: Wolverine West, L. L. C. Post Office Box 99095 Seattle, WA 981390095 Detach this wallet end and cany with you for verification of certification In-St a Representative: Rodney F. Hash y Washington State Patrol 14 610 I Fire Protection Bureau Phone Number: (206)459-0917 i Office Of ne State Fire Marshal Importer: W st,L.L.C. Date of Issue Expiration Date License Number License Number; s. � Pe of License; January 24,2013 January 31,2014 C-04138 Phone Number: Expiration pate: J 4 �^9 30*420-012(R 9105) tate rite ors i ature ee Signature ,qi 'k:l^ t,��' x, 'STVI�,�, x° e ^u" Fi r, : , .h_ .,F.,,.k Mc• "s..`.i A - * v3. r �� .�."�'� x3r. � r >.a .{, .gi �r t.a ,.sr 6 # � _�hJ�t. =.i'',4, �N .r i �,. 1 7 ; .r t ; r`Aiin n tfir s { ;- 1 4Lice '41i�'2^�s...�,y�l h s• .� i r1:'S' �1 a �i � . �.,� In e General Display: Wolverine West, L. L, C. .s Post Office Box 99095 Seattle, WA 981390095 Detach this wallet card and carry with you for verifitzttioa of 0"ficatiom. res ntatiye: t R Rodney F.Y F Hash � Wael4i Won Stale Patrol 14612 �, iEit+a:7k"ralbectipn l�trresri Ph Office i ChtSmta> Marshal LI 9 I Gem l+12l play« qJ . t,L.L.C. l Leg. �se,N�11�r: '`�;. Date,Q fUSue yjx irAtion late License Numbear I tre t f I. January 24,2013 January 31, 2014 C-04138 lwatb Nrlmtter: „I Eaablrafion D�Cta; 4 . - 3000-420-012(R 9/05) jj fate Fite aturo Li see Signature Washington State Patrol 15 0 51 Fire Protection Bureau Office Of The State Fire Marshal Washington State Fireworks License Pyrotechnic Operator License Pyrotechnic Operator: Rodney F. Hash Detach this wallet card and carry with you for Licensee Location: Post Office Box 99095 verification of certification. Seattle, WA 981390095 _ - Washington State Patrol Fire Protection Bureau 15051 ' Phone Number: (206)459-0917 Office Of The State Fire Marshal I Pyrotechnic Operator .Hash Date of Issue Expiration Date License Number I License Numbe T e of Licens '` Operator January 23, 2013 January 31, 2014 P-04255 i Ex iration Dat �� `,2014 Itj I _ 3000-420-012(R 9/05) State Fire arsh cure Licensee Signature I