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HomeMy WebLinkAboutFIR2013-00020 Fire Fireworks Stand - FIR Permit / Conditions - 6/26/2013 F Inspection Line (360)427-7262 MASON COUNT r5. OF COMMUNITY DE"J ELOPMENT Phone:{360)427-9670, ext. 352 Mason County Bldg. 3 :`. ' 'edar P.O. Box 279 Shelton, WA 98584 oto FIRE PROTECTION PERMIT FIR2013-00020 APPLICANT: BELFAIR COMMUNITY BAPTIST RECEIVED: 6/11/2013 CONTRACTOR: LICENSE: EXP: ISSUED: 6/26/2013 SITE ADDRESS: 23300 NE STATE ROUTE 3 BELFAIR EXPIRES: 12/26/2013 PARCEL NUMBER: 123325000015 LEGAL DESCRIPTION: SAM B. THELER'S HOME &GAR TRS TR 7 EX N 25' OF &TR 7-A& 713 DOR#4656-001 PROJECT DESCRIPTION: FIREWORKS STAND PERMIT 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?: 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 Stand Permit $100.00 $100.00 Auto Fire Alarm?: Third Floor;: Total: $100.00 $100.00 FIR2013-00020 Please refer to the following pages for conditions of this permit. Page 1 of 6 Lonsumer Tire works may oe soia only on the Toiicyving gays ana times. June 28th from 12 moon to 11 PM June 29th to July 5th from 9 AM to 11 PM July 6th from 9 AM to 12 noon X Only Washington State Fire Marshal approved class C common fire works may be sold. X A fire works stand shall not be located more than 150 feet from an approved access road. Shall be at least 100 feet from another fire works stand or separated by a road, street or highway at least 30 feet in width. Shall not be located any closer than allowed by the attached table to other structures or exposures or be located closer than 100 feet from any flammable liquid or gas dispensing device, or 300 feet from any flammable liquid or gas bulk storage or dispensing facility. X The minimum areas around a fire works stand, as specified in the attached table, shall be kept free from dry grass, brush, or combustible debris. This area shall be marked and flagged. X Motor vehicles or trailers may not be parked within 20 feet of the fire works stand except when delivering, loading or unloading fireworks. X Fireworks shall not be discharged within 300 feet of any fireworks stand. A sign stating "No Fireworks discharge within 300 feet' in letters at least 2 inches high and in contrasting color shall be posted conspicuously on all sides of the structure. X No smoking shall be allowed within the fireworks stand or flagged off area. Signs stating " No Smoking Witin 100 feet' in letters at least 2 inches high and in contrasting colors shall be posted conspicuosly on all sides of the structure. X All battery powered equipment, electrical equipement and cords shall be UL listed and used in accordance with that listing. Extension cords shall be of an industrial grade type and shall be protected from physical damage. X All heating devices shall be UL listed. Only heating devices with sealed type elements shall be used, i.e. oil filled or water filled radiator type. Open flame or open element heating devices are prohibited. X Generators shall be located a minimum of 20 feet from any fire works stand. Fuel storage is limited to 5 gallons. X A minimum 24 inch wide isle shall be maintained inside the full length of the stand. Customers are not allowed inside the fireworks stand. There shall be a minimum of 2 exits at least 28 inches in width located at oppsite ends of the stand. These exits shall remain unlocked and unobstructed during hours of operation or when stand is occupied. X Sleeping inside a fireworks stand is prohibited. FIR2013-00020 Please refer to the following pages for conditions of this permit. Page 3 of 6 The location of the nearest- phone shall be posted in the fireworks stand. All occupants of the stand shall be info---.-,.P as to the location of this The local emergency phone number, 911, and the address of the fireworks stand shall be conspicuously posted insic : le stand. X There shall be a minimum of 2 approved 2 1/2 gallon pressurized water fire extinguishers located adjacent to eac . exit door. X Cooking, open flame or any type of open flame equipment is prohibited in a fireworks stand. X Fireworks stands shall be locked when unoccupied and not open for business if fireworks are storged in the stand during these times. Fireworks stand shall not be locked when occupied. Fireworks maybe removed or transferred to a temporary storage structure or location approved as part of the license and permit. X Fireworks may be stored in a locked and secured retail fireworks stand, truck, container or trailer that is at least 20 feet from the fireworks stand during business hours, or in a locked and secured metal or wooden garage, shed, barn or other accessary building that is at least 20 feet from the fireworks stand. X At least one person 18 yrs of age or older shall be on duty in the fireworks stand when fireworks are being sold to the public. Such person shall be responsible for the supervision of the fireworks stand and its operation. No person under tha age of 16 shall be allowed to occupy the fireworks stand when open to the public. X It is illegal to knowingly sell fireworks to persons under the age of 16. A sign stating "No Sales Of Fireworks to Persons Under the age of 16" in letters at least 2 inches high and in contrasting color shall be posted on the front of the stand. A photo ID is required and it is responsiblity of the seller to require proof of age. Driver's license or photo ID showing date of birth issued by a public or private school, state, federal or foreign government is acceptable. 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 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 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 inspection. OWNER OR AGENT: DATE: FIR2013-00020 Please refer to the following pages for conditions of this permit. Page 4 of 6 T1 W CONCRETE MECHANICAL MANUFACTURED HOME Date By Footings /Setbacks L Ribbons D Gas Piping CA) Interior Date By Interior-Date By Date By O O Extenor Date By Exterior-Date By n C Set-up O p Point Load!Isolated Footings INSULATION _.__„ Date By BG 1 SLAB INSULATION — Date By Data By FIRE DEPARTMENT C Foundation Walls Z Floors date Date By Date By DECKS FRAMING Walls Date By W Date By Data By PROPANE TANKS PLUMBING vault Date By N Date By. OTHER Groundwork Attic Date By Type. Date B y Date By D.W.V DRYWALL Type- Int.Brace Wall Dam T Date By Date By � y FINAL INSPECTION c m Water Line Fire Seperation 8 Date By Date By Date By b o Pass or Request Inspect. o Type of Insp. Fail Date Date Done By Comments c o s -t- , r-,�. ( -26 6-.27- t ---) 3 f0 N t0 lD O � ... .............. O 7 a o' N O M S N O N lD U1 O 0) SITE DIAGRAM Loc No: W W iM �4St�2 Address: Ordinance of: �2 22m n E Parcel No: 13 L106( S Store/Center: -=��u-�-•-r ���fr%�� u i Stand Faces Direction of: City& State: RaLlt/2- Stand Size: y Cross Streets: Notes: ��ri 1 s t.JA 5- -k 9 , �� a I � � G� � I - i ANGES 1C EMIT CHANGES FOR APPROVAL PRIOR TO PERFORMING WORK l%��. OW MASON COUNTY FIRE MARSHAL Mason County Bldg.III 426 W Cedar St PO BOX 186 Shelton,WA 98584 (360)427-9670 Ext.273 + 3 CODE ENFORCEMENT FIRE INSPECTIONS FIRE INVESTIGATION PUBLIC EDUCATION STANDARDS FOR THE OPERATION OF RETAIL FIREWORKS STANDS Sales Consumer fire works may be sold only on the following days and times. • June 28th from 12 noon to 11PM • June 29th—July 5th from 9AM to 11PM • July 61h from 9AM to 12 noon • December 27th— 315t from 12 noon to 11PM Approved Fireworks Only Washington State Fire Marshal approved Class C common fireworks may be sold. Fireworks Stand Location • A fireworks stand shall not be located more than 150' from an approved access road, • Shall be at least 100' from another fireworks stand or separated by a road, street or highway at least 3 0' in width, • Shall not be located any closer than allowed by the table below to other structures or exposures, • Or be located closer than 100' from any flammable liquid or gas dispensing device, or 300' from any flammable liquid or gas bulk storage or dispensing facility. Retail Fireworks Stands—Minimum Clearances Buildings Combustibles Property Line Parking Motor Vehicle Motor Vehicle Traffic, Traffic, Public Road Private Way Back of Stand 20' 20' 5 20' 20' 5' Side of Stand 20' 20' 5' 20' 20' 5' Front of Stand 20' 20' 20' 20' 20' 20' Surrounding Area around Fireworks Stands • The minimum areas around fireworks stands, as specified above, shall be kept free from dry grass, brush or combustible debris. This area shall be marked and flagged. • Motor vehicles or trailers may not be parked within 20' of the fireworks stand except when delivering, loading or unloading fireworks. • Fireworks shall not be discharged within 300' of any fireworks stand. A sign stating No Fireworks Discharge Within 300' in letters at least 2"high and in contrasting color shall be posted conspicuously on all sides of the structure. • No smoking shall he allowed within the. fireworks stand or flagged nff area Riom Ostino,No Smoking Within 100' in letters at least 2"high and in contrasting color shall be posted conspicuously on all sides of the structure. Electrical Supply& Usage • All battery powered equipment, electrical equipment and cords shall be UL listed and used in accordance with that listing. Extension cords shall be of an industrial grade type and shall be protected from physical damage. • All heating devices shall be UL listed. Only heating devices with sealed-type elements shall be . . .. prohibited. • Generators shall be located a minimum of 20' from any fireworks stand. Fuel storage is limited to 5 gallons. Fireworks Stand Operations • A minimum 24"wide isle shall be maintained inside the full length of the stand. • Customers are not allowed inside the fireworks stand. • There shall be a minimum of 2 exits at least 28"in width located at opposite ends of the stand. These exits shall remain unlocked and unobstructed during hours of operation or when stand is occupied. • Sleeping inside a fireworks stand is prohibited. • The location of the nearest phone shall be posted in the fireworks stand. All occupants of the stand shall be informed as to the location of this phone. • The local emergency phone number, 911, and the address of the fireworks stand shall be conspicuously posted inside the stand. �I • There shall be a minimum of 2 (two) approved 2 1/2 gallon pressurized water fire extinguishers located adjacent to each exit door. • Cooking, open flame or any type of open flame equipment is prohibited in a fireworks stand. • Fireworks stands shall be locked when unoccupied and not open for business if fireworks are stored in the stand during these times. Fireworks stands shall not be locked when occupied. Fireworks may be removed or transferred to a temporary storage structure or location approved as part of the license and permit. • Fireworks may be stored in a locked and secured retail fireworks stand, truck, container, or trailer that is at least 20' from the fireworks stand during business hours, or in a locked or secured metal or wooden garage, shed,barn or other accessory building that is a least 20' from the fireworks stand. • At least one person 18yrs of age or older shall be on duty in the fireworks stand when fireworks are being sold to the public. Such person shall be responsible for the supervision of the fireworks stand and its operation. No person under the age of 16 shall be allowed to occupy the fireworks stand when it is open to the public. • It is illegal to knowingly sell fireworks to persons under the age of 16. A sign stating"No Sale Of Fireworks to Persons Under the Age Of 16" in letters at least 2"high and in contrasting color shall be posted on the front of the stand. A photo ID is required and it is the responsibility of the seller to require proof of age. Driver's License or Photo ID showing a date of birth issued by a public or private school, state, federal or foreign government is acceptable. +r U t''\ 1 (7 1233zsa � OO � � F oc 'C) COP `" APPROVED MASON COUNTY FIRE MA SHAL DATE y' BY -. SUBJECT TO FIELD INSPECTI*'_ THESE PLANS MUST BE ALL APPLICABL CODES MALL APPLY. ERRORf. ON THE JOB SITE AND/OR OMISSIONS ON PLANS ARE SOLE R@- SPONSI OIL ITV OF OWNER/CONTRACTOR. CORR[C FOR INSPCLTION- TIONS REOUIRED FROM FIELD INSPECTION SF4kLl BE AT OWNER/CONTRACTOR'S EXPENSE. THIS AP- PROVAL DOES NOT GRANT TO ANY PERSON THE. RIGHT TO VIOLATE ANY CIT" OR STATE I A',Wk. 1_ �' Mason County IM Fireworks Permit Application � � PO BOX 186 �,,,,�� 426 W Cedar St Permit# FIR 1 p 13_ OCL�20 ��` Shelton WA 98584 Receipt # (360) 427-9670 ext 273 CK # ,�023-72A Date Received (p- 0- 13 WWM6505 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: STEVEN SATTERFIELS _ Mailing Address: PO BOX 663 City: BELFAIR State: WA Zip: 98528 Contact Number (360 ) 551-5983 Sponsor Information Name: CELEBRATE THE 4TH Mailing Address: PO BOX 663 City: BELFAIR State: WA Zip: _ 98528 Contact Number (360 ) 551-5983 Washington State Fireworks License Information (Copy Required) License No.: Date of WSPFL-02437 _ Issue: 04/25/2013 ❑ 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 APPLICATION FOR RETAIL FIREWORKS STAND PERMIT WWM6507 TO: Governing body of city, town, or county in which DATE OF JUNE, 2013 fireworks stand will be located. APPLICATION: Applicant Name: Address,City,State: CELEBRATE THE 4TH 2120 MILWAUKEE WAY, TACOMA„ WA 98421 Sponsor(If other than applicant): Address, City,State: STEVEN SATTERFIELD 2120 MILWAUKEE WAY, TACOMA„ WA 98421 Location of proposed fireworks stand: [Enclose drawing of stand location] 23300 WASHINGTON 3, BELFAIR, WA BELDAIR BAPTIST CHURCH Manner and place of storage prior,during, 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: 2013 (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"' Sales For December 31st From: From: To: To: Sponsor: CELEBRATE THE 4TH Location: BELFAIR BAPTIST CHURCH 23300 WASINGTON 3 BELFAIR, WA /s/ /s/ 4FOR STEVEN SATTERFIRLD Signature of Official Granting Permit Vigriature of Applicant Title: Agency: Date: Permit Number: Licensee Name: CELEBRATE THE 4TH License Number: 02437 3000-420-013(Rev.2/05) Washington State Patrol 1519 7 Fire Protection Bureau Office Of The State Fire Marshal Fireworks Stand License Washington State Fireworks License License is Non-Transferable and Valid for Only One Stand Licensee Information Celebrate the 4th! 2120 Milwaukee Way State Fire Marsh l Sign t Tacoma, WA 98421 License Number: WSPFL-02437 Detach this wallet c d d arry with you for verification o ce ' cation. Stand Information Washington State Patrol Contact Person: Reina Hoyt Fire Protection Bureau 15197 Office Of The State Fire Marshal Phone Number: (206) 326-9458 ANNUAL FIREWORKS STAND LICENSE County: Mason Date of Expiration Date of Issue Licensee: Cele te-a� ! Stand Number: SN-07934 January 31, 2014 April 25, 2013 Contact Person: R License Number: Stand Number: S lid For One Stand] Date of Expiration: Ja Location: Stand Location: ('land Locatio ompleted By Licensee] [Stand Location To Be Completed By Licensee] �-- zrm_Aln_1111 10 omc� crsrA R;ro �.cti� c r...� r;rnncry C;onah„s. PERMISSIONAGREEMENT This agreement is de between � Pti / f nrl. i� S�, OU rA^--as Licensor, and ` it/ long With AMERICAN PROMOTIONAL EVENTS, INC— NORTHWEST (dba TNT ireworks) as licensee for the purpose of allowing the retailing of Class"C" Fireworks for the following location: & (ra,Y CJ.11.�r4r.�.'I�� l��.��,_tf elvvei4 --13,to 3 Store/Shopping Center game Address VL i -1 ,X Lw-q 12"3311;� - SO-- bcn1 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 8a', 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- 2 Z — Z / 3 , 2 by the parties signing below. Landlord/Manager, Licensor Retai , Licensee _760- Z7S--6o.31 Landlord Contact Phone Number ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �.i H/1/2013 6/3/2013 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). CONTACT PRODUCER Lockton Companies,LLC NAME: 3280 Peachtree Road NE,Suite 800 PHONE FAX Atlanta GA 30305 E-MAIL o Ext: AIC No (404)460-3600 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Scottsdale Insurance Company 41297 INSURED American Promotional Events,Inc. INSURER B: 1359629 DBA 7'NT Fireworks,Inc. INSURER C: P.O. Box 1318 INSURER D: 4511 Helton Drive INSURER E Florence AL 35630 INSURER F COVERA 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY Y N CPS1612503 I1/1/2012 11/l/2013 EACH OCCURRENCE DAMAGE TO RENTED X MMERCIAL GENERA ABILITY PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE OCCUR ME 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 $ 2,000,000 POLICY PRO- JECT X L 0 C $ 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 $ XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB HCLAIMS-MADE AGGREGATE $ XXXXXXX DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY / ECUTIVE ❑ E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? NIA $ XXXXXXX (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 I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) 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 Celebrate the 4th PO Box 186 426 W Cedar X Shelton WA 98584 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD © 98H- 1 O CORD CORP TION.All rights reserved 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 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 a_int ine . Signed.. FOR STEVEN SATTERFIELD Date 06/2013 �— FOR OFFICIAL USE ONLY BELOW THIS LINE Accepted By: Date: