HomeMy WebLinkAboutFIR2006-00030 Fireworks Stand - FIR Permit / Conditions - 12/27/2006 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 FIR2006-00030
APPLICANT: NORTH MASON PEE WEES RECEIVED: 6/27/2006
CONTRACTOR: LICENSE: EXP: ISSUED: 6/27/2006
SITE ADDRESS: 23881 NE STATE ROUTE 3 BELFAIR EXPIRES: 12/27/2006
PARCEL NUMBER: 123294100081
LEGAL DESCRIPTION: TR 8=A OF NE SE PCL 3 OF BLA#04-37
PROJECT DESCRIPTION: Fireworks Stand
GENERAL IN FR System Information
Type of Use:
Fire District: Sprinkler Heads: Audible Switches: Pull Stations:
Hood&Duct?: 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 Display Permit $100.00 $100.00
Total: $100.00 $100.00
FIR2006-00030 Please refer to the following pages for conditions of this permit. 1 of 3
i
CASE NOTES
FIR2006-00030
CONDITIONS FOR
FIR2006-00030 -
1.) Shall meet minimum requirements of the Mason County Standards for the Operation of Retail Fireworks Stands (see attached).
X «
Inspection by the Fire Marshal required before opening. X ez
This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied.Proof of continuation of work is
by means of a progress inspection.The ownerorthe agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above
described property and structure for review and inspecti
OWN ER OR AGENT: DATE: (O O
r• ,
FIR2006-00030 Please refer to the following pages for conditions of this permit. 2 of 3
J ' Mason,County
Fireworks Permit Application
.. _ J-mm
PO BOX 186
426 W Cedar St Permit# FIR 9z C) °-
Shelton WA 98584 .
(360)427-9670 ext 273 Receipt # ��—EX��
CK #
Date Received _
A Permit for the Retail Sales or Public display of fireworks is required. A'completed
application with required documentation and fees shall be submitted for Fire Marshal
review. A permit will be issued upon satisfactory site inspection by the Fire Marshal.
Applicant Information
Name:
Mailing Address- �
City: CL I State: LA Y1 Zip: Cl S 52$
Contact Number
Sponsor Information
Name:
Mailing Address: JE ��
City: _ag� State: ' - LW Zip:
Contact Number
Washington State.Fireworks License Information (Copy Required)
License No.: cj-,ss P i=L -o b So (z Date of
Issue- - C, -O �V
ElPyrotechnic Operator License Fireworks Stand License
Bond or Certificate of Insurance
(copy of Certificate/Bond Requir d)
Provider:
Insured: ev`t(r� O MCA Q� G
Certified Holder:
Location of stand/display
AddressALJ
: 2
Directions to Site:
Parcel Number.: I _ _
Legal Description:
Legal Property Owner: ; 14
* * Please see the reverse side to complete your application
f
a
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 I
designated display areas to:
• Fire Hydrants • Property Lines
• Buildings . parkg
• 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 landing area
Q ?0
J
\P \
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 dischar a of fireworks
shall be maintained.
Signed Date 3A�
FOR OFFICIAL USE ONLY BELOW THIS LINE
Accepted By: Date:
l