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HomeMy WebLinkAboutFIR2011-00029 Final Fireworks Stand - FIR Permit / Conditions - 6/27/2011 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 a FIRE PROTECTION PERMIT FIR2011-00029 APPLICANT; JOHN MILLER RECEIVE=D:6/612011 CONTRACTOR: LICENSE: EXP: ISSUED:6123120111 �_ SITE ADDRESS; 22950 NE STATE ROUTE 3 BELFAIR EXPIRES: 1212312011 PARCEL,NUMBER: 123325000044 N LEGAL DESCRIPTION: SAM S. THELER'S HOME& GAR TRS TR 19-13 O ``' PROJECT DESCRIPTION: FIREWORKS STAND 1 GENERAL INFORMATION System Information Type of Use: 2STND Fire District' 2 Sprinkler Heads: Audible Switches: Pull Stations: ' Hood 8� Duct?'-. N Flow Switches: Usual Devices: Door Releases: � Dry Chemical?,. N Pressure Switches:: Smoke Detectors: Duct Deteclors: n WeL Chemical?: N Zones: Heat Detectors: Sprinkler?: N Standplpe7: N SQUARE FOOTAGE FEES on toringCompany; FirstFloor: Type Amount Due Amount Paid Monitoring Phone No.:() - Second Floor: Fireworks Stand Permit $100.00 $100.00 Auto Fite Alarm?:N Third Floor;: A Total: $100.00 $100-00 C N O C� O O]. O� ---N t7 �N N o FIR2011-00029 Please roarto the following pages for conditions of this permit. Pagel of 6 CASE NOTES F1R2011-00029 N Y CONDITIONS FOR FIR2011-00029 LD N 0) O M co y H M J n n N ti J y C� O r> ..O C�R. 0 w Oo O �o N M� N� FIR2IQ11.00029 Please refer to thefollowing pages for conditions of this permit - Page 2 of 6 1,) ner 1 a e ible to post the assigned addre9s and/or purchase and post private road signs in accordance with Mason County Title 14.28, M,- Q LO O N O) O CO 4 ti 1 Y. J 7 CO 0 I �N O d U) C O O O � h O O CA (6 O O � GV N m ¢ FIR2011.00029 Please roller to the following pages for conditions of th)s permit. Page 3 of 6 2,) Consumer fire works may be sold only on the following days and times. June 28th from 12 noon to 11 PM J July 51th from 9 AM to 11 PM my 6th from to 12 noon X — n� Only a ton State Fire Marshal approved class C common fireworks may be sold. X A fire w s 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 LD sto or sing facility. o X N °' The inimum areas around afire works stand, as specified in the attached table,shall big kept free from dry grass, brush, or combustible debris. This o ard and flagged. X ea)s e Motor or srs may not be parked within 20 feet of the flre works stand except when delivering, loading or unloading fireworks. x X Firewo shall not be discharged within 300 feet of any fireworks stand. A sign staling"No Fireworks discharge within 300 feet"in letters at least 2 inches higpowered g color shall be posted conspicuously on all sides of the structure. a X o " Nallowed within the fireworks stand or flagged off area. Signs stating"No Smoking Witin 100 feet/In letters at least 2 inches high and o inshall be posted consplcuosly on all sides of the structure. X Alquipment, electrical equipement and cords shall be UL listed and used in accordance with that listing. Extension cords shall be of an indu r4Qf-gre a type and shall be protected from physical damago. X All heVnot l be UL listed. Only heating deyiGes with s-ealed type elements shall be used, i.e. oil filled or water filled radiator type_Open flame i or opg devices are prohibited. c r X � N Generated a minimum of 20 feet from any fire works stand. Fuel storage is limited to 6 gallons. 0 X o m CD A mine isle shall be maintained inside the full length of the stand. o Custoed inside the fireworks stand. There shall be a minimum of 2 exit&at least 28 inr.hP;in width lnr�,tP.i at nnn�itg�nr�e of fhw clanri. These ' s remain unlocked and unobstructed during hours of operation or when stand is occupied, o X o Sleepin a fireworks stand is prohibited. X N (� N m FIR2011-00029 Please refer lo the following pages for conditions of this permit. Page 4 of 6 The Ipoall crest phone shall be posted In the fireworks stand. All occupants of the stand shall be informed as to the location of this phone. The toca ergency phon number, 911,and the address of the fireworks stand shall be conspicuously posted Inside the stand. LO There sh i um of 2 approved 2 112 gallon pressurized water fire extinguishers located adjacent to each exit door. X Cooking, o fl a r any type of open flame equipment is prohibited ini a fireworks stand. X Fireworks shall be locked when unoccupied and not open for business if fireworks are storged in the stand during these times. Fireworks stand shall noPaybe hen occupied. Fireworks maybe removed or transferred to a temporary storage structure or location approved as part of the license LD o and per N X 0) Fireworred in a locked and secured retail fireworks stand, truck, container or trailer that is at least 20 feet from the fireworks stand during M busines 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 sl X At lea person 16 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 resP onsi r the supervision of the fireworks stand and its operation. No person under tha age of 16 shall be allowed to occupy the fireworks stand a x whe pen Itthe public. '1 X J It is ' al to knowingly sell fireworks to persons under the age of 16.A sign stating"No Sates Of Fireworks to Persons Under the age of 16"in letters at lea 2 In 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 L proof age Driv erase or photo ID showing dale of birth issued by a public or private school, state,federal or foreign govemment is acceptable. X 3,) Valid it, e o si X This permit becomes null a d if work or construction authorized Is not commenced within 180 days,or if construction ar work is suspended for a period of 180 days at any lime after work is commenced idence of contlnualion of work Is a progress Inspection virilhin the 180 day period. Final insperflorr must be approved before building can be occupled. a Proof of contlnuation of work is b means of a progre ins on,The owner or the agent on the owners behalf,repFekents_Ihat t�Jlrf4�ll�tJon provided is equrgtq_e9�_gr.7nis ti my acre o the rib perty and structure for review and inspection. empToyeas o�M3sari N OWNER OR AGE - DATE; o �r � o o CO ero O U w .a a � o o <— PI N M \ N op C: o FIR2�11-DOi129 Please refer to tile following pages for conditions of this permit. Pago b of 6 D 7 T ' .-I CONCRETE MECHANICAL MANUFACTURED HOME r r Footings /Setbacks Date By Ribbons fTi Gas Piping� C Interior Date By Interior-Date By Date By L 00 Exterior DaW BY Exterior-Da49 B N INSULATION = co Point Load/Isolated Footings Date By Z B(3/SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By Date By Date By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Type: Cate By Date By Date By D.W.v DRYWALL Type: Int Brace Wall Date By T pe By - H Date By FINAL INSPECTION N m Water Line Fin Separation Date B Date B CD Cate By Y Y , O o Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments o 3 fQ N fD N -w O n O 7 tl O 7 N O ft .+ to � I lD { I I I t �D iU (L] CD O) O 0) Mason County HE Hall= Fireworks Permit Applicationom- M. , PO BOX 186 426 W Cedar St Permit# F.IR V11- =0 Shelton WA 98584 (360) 427-9670 ext 273 Receipt # CK # Date Received Cell I 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: � ffiyATNA� fc LcrK- Mailing Address: w j4l-rF (f City: &E&&CjC State: w A Zip: `2r3&Cko Contact Number (3�6) CLa- �� 2 Sponsor Information Name: `t/ 4 Mailing Address. City: State: Zip: Contact Number ( ) Washington State Fireworks License Information (Copy Required) License No.: W SP�L _� -Z� Date of Issu ElPyrotechnic Operator License Fireworks Stand License Bond or Certificate of Insurance (Copy of Certificate/Bond equired) 1 Provider: r i 2D ('I=Ad 1KiS44 I Insured: Fui�..ox�� Certified Holder: . SaL.IF Location of stand/display Address: 227y0 NC SnqrC C1�,fie 3 96-L FA Irt Directions to Site. Parcel Number: _ 3 Z S r9 DO Legal Description: Legal Property Owner: Ja D- sJ (-14 * * Please see the reverse side to complete your application 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 designateI display areas to: • Fire Hydrants N • Property Lines Buildings Parking•� Combustibles �' • Public Roads and Right of Ways *I Fire Lanes �' : Private Roads and Right of Ways o Trees/Brush Landmarks • •Utilities and Gas NIk • Mortar separation distance • Desi ated landing area C 7 Applicants Affidavit I certify that the information provided herein is accurate and that compliance with all Count an Feder I laws pert ' ng to the sales or discharge of fireworks I b maintain Signed Date LFOR OFFICIAL USE ONLY BELOW THIS LINE Accepted By: Date: BEUAlft 4TB OF JULY SITE 22940 NE State Route 3, Belfair,WA 98528 PARCEL# 123325000044 C O P V Or �r. M44 w t * W r " eS S .. M` S°, . Lc�'`�, / 05/17/2011 10:23 FAX 360 779 4537 SKY PIX z 001 May 06 11 01156p Gordon Sound 3606921015 p,1 FIREWORKS LICENSE AGREEMENT This agreement is made between Joe Solif, as licensor and Boorntown Productions as licensee for the said purpose of allowing retail sales of Consumer. Fireworks from,the following location: 22950 NE STATE ROUTE 3 BELFAIR Parcel tax ID4123325000044 The licensor represents that it owns,or controls the use of the lot as listed above and agrees to grant licensec the right to operate a retail firework stand on the premises for the period of June 22,2011 through July 8,2011 for a license fee of$1000.00 due no later than July IS",2011. The licensee shall pay all cost involved in the election, operation and maintenance of the stand, and shall guarantee that the premises shall be returned to the original condition after removal of the stand_ The 1:1,censee will provide liability insurance coverage and provide to the licensor, brfore occupancy. The insurance shall name the licensor as an additional insured,and licensee will hold the licensor h,arailess from any claims arising from the maintenance or operation of the structure. The licensee shall pay for and obtain licenses and permits required by law and post any performance bonds which might be required The li.censce shall guarantee than the stand is e>perated in a business like mariner and adhere to all local state regulation.. If the property is sold,ingresslegress changed, or location impacted due to construction or the like,them this license is sabjeet to revocation and refund of any payments made. LICENSOR: LICENSEE: Joe Solif-Owner Miller,/,Boomtown Productions Phone 360-440.4973 ?hone:360.620.1732 r�x 36 -774- J,5 37 DATE(MMIDWYYYr ACORO CERTIFICATE OF LIABILITY INSURANCE 5/17/2011 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 CAMONTACT N David Connolly Insurance Agency Inc, PWC,No ExII:HONE I�.No1: 9393 Bayshore Dr E-MAIL ADDRESS: Silverdale,WA 98383 PRODUCER CUSTOMER t t INSURERS)AFFORDING COVERAGE NAIC s INBURED INSURER A:National Fire&Marine Ins.Company Aurora Fireworks LLC INSURER B: 29399 Beach Dr NE INSURER C: Poulsbo,WA 98370 INSURER o: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. LTR TYPE OF INSURANCE POLICY NUMBER POLICY YYY (iAPOLMtD�OIYY�YY Lam GENERAL LIABILITY X 72LPS-013925 5/1/2011 5/1/2012 EACHOCCURRENCE S 1,000,000.00 DAMAGE X C't.IMEFICIAL C3Er.ERAL LVBLjTY c � $ 100,000.00 A CLAIMS-MADE �OCCUR MED EXP(Any one person) s 5,000.00 PERSONAL&ADV INJURY $ 1,000 000.00 GENERAL AGGREGATE s 2,000 000.00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 1,000,000.00 X I POUCY I I PRor` LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 ima avldenU ANY AUTO BODILY tNJURY(Per Person) S ALL OWNED AUTOS BODILY tWURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE H?RED AUTOS Per accident) $ NON-OWNED AUTOS $ S UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LLAB CLANMS-MADE AGGREGATE 5 DEDUCTIBLE 5 RETENTION STORATU 5 WORKERS COMPENSATION WC STIMrT CR AND EMPLOYERS'LIABAM v YiN ANY PROPRIETOWPARTNEREXECUTrvE EL EACH ACCQFNT $ OFFICER,I,EMBER EXCLUDED? El N 1 A IMW%t* p in" E.L.DtSBASE-EA EMPLOYEE s Nye��describe whder INSCRIPTION OF OPERATIONS wow E.L DISEASE-POLICY LiM1T S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AdditwW Rer wits Sch*&"M it more space Is required) Mason County and Boomtown Fireworks are listed as an additional insured. CERTIFICATE HOLDER CANCELLATION Joe Solif SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 25603 NE State Route 3 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Beffair,WA 98528 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORZED REPRESENTATIVE 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Washington State Patrol 1 2 6 1 5 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 Boomtown Productions 15156 Northwest Hite Center Road State Fire M rshal gat e Seabeck, WA 98380 License Number: WSPFL-02027 Detach this u c and cant'with you for verifi lion f certification. Stand Information -- - --- - -- ----- - - Washington State Patrol 12 615 Contact Person: John Miller Fire Protection Bureau Phone Number' (360) 620-1732 Office Of The State Fire Marshal ANNUAL FIREWORKS STAND LICENSE County: Mason Date of Expiration Date of Issue Licensee: Boom v ctions Stand Number: SN-06007 January 31 2012 April 12 2011 Contact Person: 7oh _ iIl i1f' License Number: W 0 {} 1 Stand Number: S id For One Stand] Date of Expiration: � ' , Stand Location: 27,.gSD li an 0 -S't'MC. 2v3 �V�c �- Location: r ( tand Locatio m d see] (Stand Location To Be Completed By Licensee) 3000-420-012(R 9/05) State Fire Marsp, i ature Licensee Signature MASON COUNTY FIRE MARSHAL t Mason County Bldg.111 426 W Cedar St PO BOX 186 Shelton,WA 98584 (360)427-9670 Ext.273 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 28"' from 12 noon to 11PM • June 29th—July 5th from 9AM to 11PM • July 6ffi from 9AM to 12 noon • December 27t'—31s`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 beat least 100' from another fireworks stand or separated by a road, street or highway at least 30' 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 be allowed within the fireworks stand or flagged off area. Signs stating 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 used, i.e. oil filled or water-filled radiator type. Open flame or open element heating devices are 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. " • 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. z-3 3 ©o yy APPROVES MASON COUNT`( YIRE 4A S , DATE L- B SUB.IECT T FIE D INSPECTION_._ ALL APPLICAm COOES SMALL APPLY. ERRORS AMOiOR OMISSIONS ON PLANS ARE SOLE RE SPONSI6ILITY OF OWNER/CQNTqi-Ny ;PF .4 S"' TIO.:REOUIREO FROM FIELO IPECTION SK4Ll BE AT OWNER/CONTRACTOR'S EENSc- THIS AP PROVAL NOES NOT GRANT TO P*PSON 7NE RIGHT TO VIOLATE ANY CITY On STATE Ll,%-- ..-._...-. CHANGES SUBMIT CHA14GES FOR APPROVAL PRIOR TO ER=ORMING WORK i i