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HomeMy WebLinkAboutFIR2006-00017 Cancelled Fireworks Stand - FIR Permit / Conditions - 12/28/2006 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)427-7262 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670,ext.352 Shelton,WA 98584 FIRE PROTECTION PERMIT FIR2006-00017 APPLICANT: TEN FIREWORKS RECEIVED: 6/1/2006 CONTRACTOR: LICENSE: EXP: ISSUED: 6/28/2006 SITE ADDRESS: ............................... EXPIRES: 12/28/2006 PARCEL NUMBER: 123294190022 LEGAL DESCRIPTION: TR 2-B OF NE SE LOT: 2 OF SP#2929 PROJECT DESCRIPTION: Fire Work Stand GENERAL INFORMATION System Information Type of Use: Fire District: Sprinkler Heads: Audible Switches: Pull Stations: Hood & Duct t: Flow Switches: Visual Devices: Door Releases: Dry Chemical?: Pressure Switches:: Smoke Detectors: Duct Detectors: Wet Chemical?: Zones: Heat Detectors: Sprinkler?: Standpipe?: SQUARE FOOTAGE FEES Monitoring Company. First Floor: Type Amount Due Amount Paid Monitoring Phone No.:0- Second Floor: Auto Fire Alarm?: Third Floor;: Fireworks Stand Permit $100.00 $100.00 Total: $100.00 $100.00 FIR2006-00017 Please refer to the following pages for conditions of this permit. 1 of 3 CASE NOTES FIR2006-00017 CONDITIONS FOR FIR2006-00017 1.) Shall meet minimum requirements of the Mason County Stan rds he Operation of Retail Fireworks Stands (see attached). X �J Inspection by the Fire Marshal required before opening. X Ensure a conflict does not exist with proposed construction activities and this permitted site. X This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended fora period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The ownerorthe agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review a d inspection. OWN ER OR AGENT: DATE: Off/ r FIR2006-00017 Please refer to the following pages for conditions of this permit. 2 of 3 ./2a/2004 14:20 FAX 960 427 7798 MASON NCOoPERMIT CTR Q 002/006 Mason County Fireworks Permit Application PO BOX 186 r 426 W Cedar St Permit# FIR 'p( - x Shelton WA 98584 r Receipt # _ (360)427-9670 ext 273 CK # Date Received —� A Permit for the 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 Wor ti Name:�TTj(fW(jVK 5 c Mailing Address: City: eo V11.1 State: WA zip: Contact Number 0 SponsorZoA n Name: n Q ►�1 vCWdvtS Mailing ress: city: duo Z State: ' ; . _ ZIP: Contact Number 0 91� L 2 Vyfashington State Fireworks License Information (copy Required) License No.: Date of Wspf--�L- Gt Issue. t L] Pyrotechnic Operator License \q Fireworks Stand License Bond or Certificate of Insurance (Copy of Certificate!.Bond Required Provider: i a 7 L Insured; 6 Certified Holder: ,r Qejps, Location of stand/display Address: v ;,. Directions to Site: Parcel Number: Jol3cAli - Lfl - " Legal Description: Legal Property Owner: Q * * Please see the reverse side to complete your application 1/23/2004 14:20 FAX 360 427 7798 XASGN ,O PERMIT CTR 0 003/006 'The f6floWillkZ pertinent information MUST be provided on the site die am below Locations and Setback distances from the back, sides and front of retail sales stands or } designated to areas to. j • Fire Hydrants • Property Lures • ]Buildings • Pad* i • Combustibles • Public Roads and Right of Ways • Fire Lanes • Private Roads and Right of Ways Trees/Brush • Landmarks Ut hfies and Gas • Mortar separation distance • Designated landin area C i I } i I A0piicants Affidavit I certify that the informatipti provided herein is accurate and that compliance with al' County, to nd F e I laws pertaining to the sales or discharge of fireworks shall I i S. ed Date I i FOR OFFIG7AL USE ONLY BELOW THIS LINE } I Accepted By- Date: 01/23/2004 14:20 FAX 360 427 3 MASON' CO PERMIT CTR 10002/006 Mason County Fireworks Kermit Application Po Box 186 426 W Cedar St permit# FI ©(� -o p Shelton WA 98584 (360) 427-9670 ext 273 Receipt #�S JUN 14 CK G o MASON Co N Date Receivedlall � . uc-,A A Permit for the 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. Name: T. E,. N Mailing Address: .161 U nCSJ 1 vi Ave , City: State: vV k Zip: Contact Number CS B aq .09 LL Sponsor information Name: � , Ak1_ Mailing Address: City: _t'-t:L State: W A, . Zip: Contact Number Wlashington State Fireworks License Information (Copy Required) License No.: ''''90c, Date of Issue: C��•{l 'f s} -�� ❑ Pyrotechnic Operator License ❑ Fireworks Stand License Bond or Certificate of Insurance (Copy of Ce 0cate(Bond Required) Provider: Insured; C�rtified Holder: LLC Location of stand/display Address: Garner EAV 2 0ca Izd U; IM Cane Pact4&iBdgp iA Directions to Site: Parcel Number: 19L3a9 _ l _ oo Legal Description: ftt a $* Legal Property Owner: d 0 * * Please see the reverse side to complete your application 01/23/2004 14:20 FAX 360 427 3 MASON CO PERMIT CTR 0 003/006 I . The following,pertinent information MUST be provided on the site diagram below Locations and Setback distances from the back,sides and front of retail sales stands or designated is areas to. j • Fire Hydrants + Property Lines • ]Buildings • Parking • Combustibles • Public Roads and Right of Ways • Fire Lanes + Private Roads and Right of Ways Trees/Brush • Landmarks • Utilities and Gas • Mortar separation distance • Designated landin area A-rrAc H G --t� i A 3plicants 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 maintained. Sj gned ; �.Q f ( -{� Date FOR OFFICIAL USE ONLY BELOW THIS LM A6cepted By: Date: