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BRN2010-00016 Final - BRN Permit - 3/23/2010
Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 BURN PERMIT BRN2010-00016 OWNER: JIM JESFIELD CONTRACTOR: JESFIELD CONSTRUCTION CO. INC. 360-275-6684 --731-7703 LICENSE: JESFII*228D0 RECEIVED: 3/23/2010 SITE ADDRESS: 140 NE SEITZ DR BELFAIR ISSUED: 3/23/2010 PARCEL NUMBER: 123303390029 EXPIRES: LEGAL DESCRIPTION: TR 13 GOUT LOT 4 TR 3 SP#2280 S 26/225 PCL 2 OF BLA#01-32 PROJECT DESCRIPTION: DIRECTIONS TO SITE: BURN PERMIT LAND CLEARING ST RT 3 TO BELFAIR, L ON ST RT 300 / NORTH SHORE RD, R ON MISSION CREEK RD, R ON SEITZ DR TO SITE ADDRESS ON THE RIGHT SIDE BURN TYPE: FEES Land Clearing Type By Date Amount Receipt Burn Permit GMM 3/23/2010 $160.50 S1201000000000000499 Total $160.50 BRN2010-00016 Please refer to the following pages for conditions of this permit. 1 Of 4 CASE NOTES FOR BRN2010-00016 CONDITIONS FOR BRN2010-00016 1) P rmit incl de two• 2) inspections maximum, additional inspections will require a$73.00 re-inspection fee. X 2) Ap 'cants m s c 60.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in. X c 3) IA nts must ca``1 0.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning. 4) Valid-per it mush e to w,hila-la�t�r a. X , 5) 4�RNBAN when implemented by Fire Marshal will take effect as noted and all permits become null and void. After a burn ban has been implemented, all fires must be ex, iately. 6) Ther'fatrwing materials may not be burned: Garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural vegetation) that normally releases toxic emissions, dense smQke or obn(oxiobs`odors when burned. X --- * — 7) All material mu$ on ate from the property on whicllthe burning is to occur. 8) rt e,fire mttstnot create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property. a 9) The maximu. ile size is twenty (20)feet in diameter, with a minimum ten (10) feet firebreak around each pile. X 10) Each pile must be at least one hundred (100)feet from any structure and aileast fifty(50)feet from standing timber. I BRN2010-00016 Please referto the following pages for conditions of this permit. 2 of 4 ' 11) D burn ' wind is blowing more than seven (7) MPH. X --- 12) Do not-burn if wind is blowing from XX direction. (This will be indicated on the posted permit at the time of site inspection.) X ~ 13) A minimum 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 PROVIDE 24 HOUR FIRE WATCH. X1 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 must tie-capable of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.) X 15) It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. Permitted individual is resp`gnsible for apy rekindling on the fire/burn site. X 16) Provide excavator/dozer with a fire extinguisher at the site with a qualified operator. X �. 17) Pr i e a 24-hour fire watch. 18) The person 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 result of an enforcement action. X = 19) Access must passable with 2 wheel drive vehicle. X 20) Fire must be completely extinguished within three (3) days after ignition. 21) After the burn is complete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth. X 22) Fan is required:" X 1` 4 e BRN2010-00016 Please referto the following pages for conditions of this permit. 3 of 4 This permit becomes null and void if work orconstruction 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 owner or the agent onjb.e owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described d or review and' ti L LJ 7 OWNER OR AG � DATE: BRN2010-00016 Please referto the following pages for conditions of this permit. 4 Of 4 W z CONCRETE MECHANICAL MANUFACTURED HOME C_ oFootings !Setbacks Date Gas Piping By Ribbons `u '^- -- m 0o Intenor Date By Interior- Date By Date By N Extergr Date By Exterior-Date By Set-up rlI rn Point Load!Isolated Footings INSULATION Date By p BG/SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Walla Floors Date By Date By Data By DECKS FRAMING walls Date By Date By Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic --- Type- Date By Date By Oat© 8y MW.v DRYWALL Type- Int.Brace Wall Date By W Date By Date By FINAL INSPECTION z CD Water Line Fire SeperationCD N Date By Date By Date By CD Pass or Request Inspect. c s Type of Insp. Fail Date Date Done By Comments o �svco o�CD z3-�a Z-No CD v y O 8 a o' Z, N O CD (D O J RECEIVWSON COUNTY BURN PERMIT APPLICATION MAR 2 3 20% 426 W CEDAR ST. • PO BOX 186 • SHELTON WA 98584 6t,0150 `�5 CCC^ 11 SHELTON 360.427.9670• BELFAIR 360.275.4467 • ELMA 360.482.5269 'J APPI ft*-IQ6a& N: CONTRACT INFORMATION: Owner --,. -t s cp e kA Owner e./C( da.,s 7'. Mailin Address _0 , ( Mailing Address Pa, pow Citye(�...L,� State a Zip City ., State a- Zip Phone 7_'7 Cell Phone — Phone 7 6 o j6A 8,el Other Phone Lien/Title Holder Ole _ Contractor Reg.# Exp. E-mail address E-mail address Drivers Lic.#a E 5 F I TO 5rG Ilep DOB /d-/7-4 z.. Drivers Lic.# D.O.B. TAX PARCEL NUMBER 12 3 3 0 -3 3-9 d 0 2 y Sec. 3 0 Twn.?3 g. !-a) Fire District -2- SITE ADDRESS(please include street name numb r&city bX-7 Directions to the site S-r :%r --F 's e'en /, 5- rn. le s o S'e i fZ D r- FC&7' top o h."f/ beA,.7 d Goi+cr a rest/✓ o r- Parcel within 200'of: Saltwater❑ Lake❑ River/Creek❑ Pond❑ Wetland ❑ Seasonal RqDgzo Stream❑ Slopes or Bluffs> 15% Yes/NO Will timber be cut and sold in parcel preparation?Ye Does Site require FPA or 6 yr. Moratorium Ye Is site being converted or replanted Ye o Reason For land Clearing l�rcJo; c. r-t ctIN Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Y o Burnine is authorized subject to the following conditions: • 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 burn if wind is blowing more than seven(7)miles per hour. • Do not bum if wind is blowing from • A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must arovide 24 hour fire watch. • On Site Water is required for permits between April 15''and Oct. 15t'.A pump truck or trailer with 300 gallons of water loaded and 200 R 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 gualified 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 360.427.7761,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 burn 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 burn 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 burn 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 SITE SKETCH/NOTES 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 application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed.The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County& local fire authorities access to the above described property and structure for review and inspection.The person in charge of the fire will b5JivMe for the cost of suppression if the fire gets out of control or if APPROVED DENIED b co nece sary xti fir as result of an enforcement action. NX Date-3 -off O/ INTIALS bwa ar2ynerijRep n tive/ ontractor(indicate which one) DATE