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HomeMy WebLinkAboutFIR2014-00011 Final Fire Works Stand - FIR Permit / Conditions - 6/28/2014 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 l� FIRE PROTECTION PERMIT FIR2014-00011 APPLICANT: BELFAIR COMMUNITY BAPTIST RECEIVED: 5/28/2014 CONTRACTOR: LICENSE: EXP: ISSUED: 6/27/2014 SITE ADDRESS: 23300 NE STATE ROUTE 3 BELFAIR EXPIRES: 12/27/2014 PARCEL NUMBER: 123325000015 LEGAL DESCRIPTION: SAM B. THELER'S HOME & GAR TRS TR 7 EX N 25' OF &TR 7-A& 7B DOR#4656-001 PROJECT DESCRIPTION: FIRE WORKS STAND GENERAL INFORMATION System Information Type of Use: STND Sprinkler Heads: Audible Switches. Pull Stations: Fire District: 2 Flow Switches: Visual Devices: Door Releases: Hood& Duct?: N Pressure Switches:: Smoke Detectors: Duct Detectors: Dry Chemical?: N Zones: Heat Detectors: Wet Chemical?: N Sprinkler?: N Standpipe?: N SQUARE FOOTAGE FEES Monitoring Company: First Floor: Type Amount Due Amount Paid Monitoring Phone No.:() - Second Floor: Fireworks Stand Permit $100.00 $100.00 Auto Fire Alarm?:N Third Floor;: Total: $100.00 $100.00 FIR2014-00011 Please refer to the following pages for conditions of this permit. Page 1 of 7 1.) Sales: WAC 212-17-21505 Retailers of fireworks-General provisions. Fireworks may be sold from 12:00 noon to 11:00 PM on June 28 through 9:00 PM on July 5. Fireworks may not be sold between the hours of 11:00 PM and 9:00�/D op June 28 through July 3. Fireworks may not be sold from 12:00 midnight to July 4 through 9:00 AM on July 5. �7 Fireworks may be sold from 12:00 noon to 11:00 PM on each day from the 27th of December through the 31 st of December of each year. X Only Division 1 AG consumer fireworks, obtained from state-licensed wholesalers, not otherwise prohibited by chapter 70.77 RCW or local ordinance, and holiday r ted roducts incidental but related to these products, may be sold in retail fireworks stands. XJ c, 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 150 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 private way 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 100 feet apart or shall be separated by a road, street or highway not less than 30 feet in width. (4) Retail fireworks stands shall be located as required by table 212-17-21509 in this section and attached to the permit. 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. (5) Retail fireworks stands shall not be located closer than 100 feet from any motor fuel dispensing station, retail propane dispensing station, flammable liquid storage, or combnustible liquid storage. Retail fireworks stands shall not be located closer than 300 feet from any bulk storage of flammable or com=d or gas, including bulk plant dispensing areas. X Surrounding area arond fireworks stands: WAC212-17-21511 Retailers of fireworks-areas around the retail fireworks stand. (1) The minimum areas around the retail fireworks stand specified in WAC212-17-21509 shall be kept free of accumulation of dry grass, dry brush and combustible debris. No parking shall be permitted within this minimum area. (2) No motor vehicle or trailer my be parked within twenty feet of a retail fireworks stand except when delivering , loading or unloading fireworks. (3) Fireworks shall not be discharged within 100 feet of a retail fireworks stand. Signs reading "NO FIREWORKS DISCHARGE WITHIN 100 FEET' in letters at least 2 inches high, with the 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 2 inches high, with the principal stroke of not less than one half inch, on a contrasting background, shall be conspicuously posted on all four sid h tand. X Electrical supply and usage: WAC 212-17-21513 Retailers of fireworks stand use and construction. (1) Fireworks may be sold from: (a)," permanent structure which meets provisions of WAC 212-17-21505(3). (b)Temporary, stable structures made of wood, metal, fiberglass or other material. Any temporary fireworks retail stand greater than 400 square feet FIR2014-00011 Please refer to the following pages for conditions of this permit. Page 3 of 7 shall meet the requirments of a permanent structure, except tents or canopies as defined in the International Fire code retail stand greater than 400 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 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 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 fees. (6) Retail sal f eworks and other products which are holiday related shall be from buildings used for no other purpose. X Storage associated with retail fireworks: WAC212-17-21517 Retailers of fireworks-Temporary fireworks storage associated with the retail fireworks stand operation. (1) Temporary fireworks storage is not permanent fireworks storage. Temporary fireworks is defined as storage associated with retail fireworks sales and may only be from June 13 through July 13 and from December 12 through January 10 of the following year. Permanent fireworks storage is associated with retail or wholesale fireworks activites 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 Internaitonal Fire Code and the 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 Icoated. (3)A temporary fireworks storage facitlity 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 legel 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 20 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 20 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 a type 4 as prescribed by the International Fire code, and which is not less than 10 feet from an inhabited building where 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. FIR2014-00011 Please refer to the following pages for conditions of this permit. Page 4 of 7 (7) The local authority having juisdiction may reduce the minimum separation required 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 for all such inspections. X 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 A ION OF DAYS WILL INVALIDATE THE APPLICATION. Signature Date D c ,Ct L'- I tti i�itJ�rc c S1`, OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) FIR2014-00011 Please refer to the following pages for conditions of this permit. Page 5 of 7 10 T IM N CONCRETE MECHANICAL MANUFACTURED HOME m r L Gas Piping Footings I Setbacks Date By Ribbons D CInterior Date By Interior-Date By Date By 55 00 Exterior Date By Exterior-Date B Sat-up Q �a Point Load/Isolated Footings INSULATION Date By BG!SLAB INSULATION ---- Date By Data By FIRE DEPARTMENT C Foundation Walls Floors Date By Z 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. Dais By Date By Date By o.w.v DRYWALL Type: Int.Brace Wall Date By Date By Date By 55 FINAL INSPECTION c y Water Line Fire Separation Date By Date By Date By � O o Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments o " v m N M O n O 7 a 0 y O S fN fp 3 m co rD rn 0 M k Mason County MM Fireworks Permit Application � � PO BOX 186 426 W Cedar St Permit# FIR d ) y-000� Shelton WA 98584 Receipt # (360)427-9670 ext 273 CK #0 P(p�j WWM6 5 0 7 Date Received,5.j.z8k 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: BELFAIR BAPTIST CHURCH Mailing Address: PO BOX 160 City: BELFAIR State: WA Zip: 98528 Contact Number ( 360) 801-5682 Sponsor Information Name: BONIE BUTLER Mailing Address: PO BOX 160 City: BELFAIR State: WA Zip: 98528 Contact Number (360 ) 801-5682 Washington State Fireworks License Information (Copy Required) License No.: WSPFL-02542 Date of 2/20/2014 Issue: ❑ Pyrotechnic Operator License X❑ Fireworks Stand License Bond or Certificate of Insurance (Copy of Certificate/Bond Required) Provider: SEE ATTACHED Insured: Certified Holder: Location of stand/display Address: BELFAIR BAPTIST CHURCH 23300 WASHINGTON 3 , BELFAIR, WA Directions to Site: Parcel Number: - - Legal Description: Legal Property Owner: * * Please see the reverse side to complete your application The followine 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 display areas to: • 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 landing area SEE ATTACHED DIAGRAM 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 maintained. Signed FOR BONIE BUTLER Date 4/30/2014 FOR OFFICIAL USE ONLY BELOW THIS LINE Accepted By: Date: April 29, 2014 Fire Marshal Mason County PO BOX 186 426 W Cedar Shelton, WA 98584 Dear Fire Marshal, In preparation for the upcoming 2014, 4 t h of July season, please find enclosed with this letter all information to apply for a fireworks stand permit. I have also enclosed 1 check for $100.00 for the Permit Fee. If you have any questions or require further information please feel free to contact me at (253) 922-0800. Thank you for your time and attention to this matter, and allowing us to operate in your wonderful city! Sincerely, *iMcT-igue Licensing & Permits American Promotional Events, Inc. - Northwest Enclosure(s) AMERICAN PROMOTIONAL EVENTS, INC. 2120 MILWAUKEE WAY•TACOMA,WA 98421 TACOMA(253)922-0800•SEATTLE(253)838-1099 FAX(253)830-2930 www.tntfireworks.com DATE CERTIFICATE OF LIABILITY INSURANCE I I/1/2014 1/28/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies,LLC CONTACT 3280 Peachtree Road NE,Suite#250 PHONE FAX Atlanta GA 30305 E-MAIL (A/C No): (404)460-3600 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Everest Indemnity Insurance Company 10851 INSURED American Promotional Events,Inc. INSURER B: 1359629 DBA TNT Fireworks,Inc. INSURER C: P.O.BOX 1318 INSURER D: 4511 Helton Drive Florence AL 35630 INSURER E: INSURER F: COVERAJ9 CERTIFICATE NUMBER: 12376406 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADD SUBR POLICY NUMBER MM DDY/YYYY) (MMO DD1YYYY LIMITS A GENERAL LIABILITY Y N S18GL00242-1 3 1 II/l/2013 II/l/2014 H OCCURRENCE X MMERCIAL GENERALABILITY DAMAGES( RENTED PREMISES R NTED nee) $ 300,000 CLAIMS-MADE X OCCUR MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2 0 POLICY PRO- ? X LOC $ AUTOMOBILE LIABILITY NOT APPLICABLE (Ea accident) $ XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXXXX ALL OWNED SCHEDULED BODILY INJURY Per accident $ XXXXXXX AUTOS AUTOS $ XXXXXXX NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAR HCLAIMS-MADE AGGREGATE $ XXXXXXX DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE AND EMPLOYERS'LIABILITY YIN TORY LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER,APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S)REFERENCED. Located at Belfair Baptist Church 23300 Washington 3,Belfair,WA(WWM6507)Certificate holder is an additional insured on the General Liability as required by written contract subject to policy terms,conditions,and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12376406 AUTHORIZED REPRESENTATIVE Mason County Belfair Baptist Church PO Box 186 426 W Cedar Shelton WA 98584 � r ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD © 988- 1 O ACORD CORP ATION.All rights reserved Washington State Patrol 1 A��� Fire Protection Bureau w 1, 15991 Office Of The State Fire Marshal Fireworks Stand License Washington State Fireworks License Licensee Information License is Non-Transferable and Valid for Only One Stand Belfair Baptist Church 2120 Milwaukee Way Tacoma, WA 98421 License Number: WSPFL-02542 State F �taL 4[fis� �i rry With you for verification YcerItcation. Stand Information Washington State Patrol Contact Person: Bonie Butler Fire Protection Bureau 15991 Office Of The State Fire Marshal Phone Number: (360) 801-5682 County: Mason Date of Expiration Date of Issue ANNUAL FIREWORKS STAND LICENSE Licensee: 1390-air Baptist Church Stand Number: SN-08434 January 31, 2015 February 20, 2014 Contact Person: 46nie Butler_. License Number: Lf � Stand Number: -1}84 [valid For One Stand] Date of Expiration: J 'uar1S Stand Location: Location:[Stand Location To Be Completed By Licensee] Stan ompleted By Licensee) 3000-420-012(R 9/OS) State Fire Nfars4rlgrture Licensee Signature APPLICATION FOR RETAIL FIREWORKS STAND PERMIT WWM6507 TO: Governing body of city,town, or county in which DATE OF 4/28/2014 fireworks stand will be located. APPLICATION: Applicant Name: Address, City, State: BELFAIR BAPTIST CHURCH 2120 MILWAUKEE WAY, TACOMA„ WA 98421 Sponsor(If other than applicant): Address, City, State: BONIE BUTLER 2120 MILWAUKEE WAY, TACOMA„ WA 98421 Location of proposed fireworks stand: [Enclose drawing of stand location] 23300 WASHINGTON 3 BELFAIR WA BELFAIR BAPTIST CHURCH Manner and place of storage prior, durinE, and after sales dates: ON SITE WITH SECURITY State Licensed Fireworks Supplier: American Promotional Events NW 2120 Milwaukee Way, Tacoma, WA 98421 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FIREWORKS STAND PERMIT For The Fireworks Sales Year Of: 2014 (Must be conspicuously displayed at all times while the stand is open to the public) By virtue of having been granted a license by the State of Washington and this permit from MASON COUNTY the local governing authority, the named person, firm or organization is hereby authorized to sell U.N. 0336 I AG Consumer fireworks at the location designated herein between the following date and times: Sales For July 4`h Sales For December 31st From: From: To: To: Sponsor: BELFAIR BAPTIST CHURCH Location: BELFAIR BAPTIST CHURCH 23300 WASHj.ZIGTON 3 BELFAIR WA /s/ FOR BONIE BUTLER Signature of Official Granting Permit Signature ofrplicant Title: Agency: Date: Permit Number: Licensee Name: BELFAIR BAPTIST CHURCH License Number: 02542 3000-420-013(Rev.2/05) ov PERMISSIONAGREEMENT This agreement is rpade between Cf ti M'2m "S'r (*U rA- -as Licensor, and K long�ith—AMERICAN PROMOTIONAL EVENTS, INC — NORTHWEST (dba TNT fireworks) as licensee for the purpose of allowing the retailing of Class"C" Fireworks for the following location: ?-(r'c,Y 4 l oe.G4 Z-. 3 b� LR N�� 3 (' Store/Shopping Center r4ame Address l4 City/State Parcel Number (if required) The licensor represent that he/she owns or controls the use of the parking lot as listed above and agrees to grant licensee the right to operate a retail fireworks stand on the premises for the period of June 23, 2013 thru July 8 h, 2015. The licensee shall include the landlord and tenants as additional insured on licensee's Premises Liability Insurance. A certificate evidencing coverage shall be available upon request. The licensee shall pay all costs involved in the operation and maintenance of the stand, and shall guarantee that the premises be returned to the original condition after prompt removal of the stand. The licensee shall pay for and obtain all required licenses and permits, and post any required performance bonds with the local government. The licensee shall guarantee that the stand is operated in a business like manner and adhere to all local and state regulations. Agreed and dated 5 Z 2- — Z / , 2pe by the parties signing below. Landlord/Manager, Licensor Retai , Licensee Landlord Contact Phone Number