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Home My WebLink About146 Haller Ave_BLD93_2026 OPERATING PERMIT Department of Community Development City of Arlington• 238 N Olympic Ave. •Arlington,WA 98223 •Phone(360)403 3551 •FAX(360)403 3418 Description of Work Permitted: Temporary structure for the sale of pyrotechnics — Class 2 Conditions: The following items must be installed or available: • Fire extinguisher • No Smoking signs • Inspection by Fire Department Location: 146 Haller Street Owned by: Shopping Center Properties of Arlington Dates: June 28t' through July 4th 2013 Operated by: (check one) ❑ Owner: X Other: Discount Fireworks Owner is responsible to see that all work is done in accordance with the City of Arlington Municipal Code and all other applicable Codes. Failure to follow applicable Code(s) or any State and Federal Regulations will revoke this permit. it" 5/8/13 July 5th 2013 Building Official Date Expiration GP )N Department of Community Development City of Arlington •238 N Olympic Ave. •Arlington,WA 9$223 Phone(360)403 3551 •'FAX(360)403 3418 } Part I Applicant/Building Information Applicant's Name: �' 4AI G, L d bort Applicant's Address: E4 d3�CL� �,(�ay� ��' Gr v�; 2yez-14-1 Contact Person: - 'i9 Telephone: v Y 3.2,2- Address of Premises for which Operating Permit is requested: ❑Same as above S Other (specify): /)-� L y"Z- ..E-9j Sr yz, Tax Parcel ID #: Current Occupancy Class: Part II Type of Operating Permit An Operating Permit is required to conduct any activity or to use any class of building listed below, Please indicate the type(s) of Operating Permit(s)requested by checking each applicable box. (If you require assistance, or mould like more information, contact the City-of Arlington Building Department at 360-403-3551,) ❑Manufacturing, storing or handling hazardous materials in quantities exceeding those listed in the Fire Code (see Appendix A.) Identify the materials and quantities and describe the manner in which the materials will be manufactured, stored or handled (attach additional sheets_if necessary): fl 5 1&mt T. i'trrul-- sync 6? S z RECEIVED Devised 4/I/08 MAY Q 6 2013 Page 1 of 4 COA Engineering DePt. " -q Part II(cont'd) ❑Conducting a hazardous process or activity, including, but not limited to', any commercial or industrial operation which produces combustible dust as a byproduct, fruit and crop ripening,waste handling, spray operations, and high-piled storage (see Appendix B.)Describe the process(es) or activity(ies)to be conducted (attach additional sheets if necessary): ZUse of pyrotechnic devices in assembly occupancies (see Appendix C.)Describe the devices to be used and type of event(attach additional sheets if necessary): ❑Aboveground Storage Tank (AST) (see Appendix D) ❑Removal❑Decommissioning❑Temporary tank closure[]Changes in service Perm anent tank closure Brief description; ❑Underground Storage Tank (UST) (see Appendix D) ❑Removal❑Decommissioning❑Temporary tank closure❑Changes in service ❑Permanent tank closure Brief description: ❑Temporary Membrane Structures, including tents and canopies (see Appendix E. ,)Brief description of structure and use: 7&/ LS A -Gvoyn ��r�[�rrt d ��- /)'wiy r wir» 31" �Nln y bayn s �N�fi��a e,,vv .env 1?vcc yr oaorr s TJTL' ?f72'1c,,-r Cc: Fire Department Page 2 of 4 Part II(cont'd) ❑Special Event Operating Permit-An Operating Permit is regairEd:fo`r any special event that takes place within an occupied building; off-an outdoor mass gathering,which is outside the .scope of the permitted use (see Appendix F.) Brief description of type of gathering proposed; Part III Premises/ui.lding Information 1. Date(s) of Proposed Event(s): . VA"Z' a F r zo 2. Date of last inspection of Premises: 3. Has a Certificate of Occupancy been issued for the premises?[]Yes o Type: ]Permanent [Temporary Date of Issuance: 4. Are there currently any open Building Permits associated with the premises?' []Yes10 If yes,please describe (attach additional sheets if necessary): S. Additional Comments: SIGNATURE OF APPLICANT ' I herby certify.that the foregoing information (and all information in attached sheets, if any) is true and complete. Signature PIP plic-anIt or horize Representatives Signature DaTe Name and Title (if applicable) of person signing Application (Please print) Cc: Fire Department Page 3 of 4 FIRE PROTECTION BUREAU FIREWORKS LICENSING PROGRAM PO Box 42600 Olympia WA 98504-2600 U h,Ne (360)596-3914 FAX: (360)596-3934 APPLICATION FOR RETAIL FIREWORKS STAND PERMIT TO Governing body of city,town, or county in which DATE OF fireworks stand will be located. APPLICATION Applicant Name c. ti- Address,City,State ��1hi'Kif Sponsor(If other than applicant) Address,City,State J_47- 2 LC_ o e3 6 19 OV zI- - �8 Location of proposed fireworks stand [Enclose drawing of stand location] X 97- - 1 J" - yea 7- &Ianner am place of storage prior,during,and after sales dates ` M/A-& W IM�;ZZ v > SC�li/IzK 12 5 v ILL/L-0- State-Licensed Fireworks Supplier )204`4. NS / o1, 1v - 9SSUv �uor�^ �- S"9�fs - - - - - - - - - - - - - - - - - --- --- - - - - - - - ---- --- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - FIREWO__VD%_T1"*/&*", S STAND PERMIT For the Fireworks Sales Year of: /_? (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 as the local governing authority, the named person, firm or organization is hereby authorized to sell U.N. 0336 1 AG Consumer fireworks at the location designated herein between the following date and times: Sales for July 4th Sales for December 31sr From: Z77y o/y From: To: Fly To: Sponsor /yd Location lJi� /'�ifzl L)D.�- /4� &&_Ll ST it' /Ii'i l��'61z. 4a 9k>- 3 /s/ /s/ Signature of Official Granting Permit ignat&c c f Applicant Title Agency Date Permit Number Licensee Name G' fZ License Number 3000-420-013 (R7io9) C) r CD S r CL CDAD CD M 00 N C M o ►�+. �+ ram. • o O C� W Vi pot- Q O C) J,j `.'S fD Old 00 n � � cOwe a, W N S O � � o A. ILI 0 CD W 1 H-I J N Z O o h lb Fa' 5 to ►Ly �<o �r� A ail C) O ' bp , o Q) o cn i3'I Ln J&M L.L.C. DISCOUNT FIREWORKS 11P.O. BOX 1463 OROVILtE, WA. 9:8844 Immaculate Conception Catholic-Church of Arlington will be operating our Firework Stand located at the Food Pavilion — .146 Haller Street. Their non-profit 501C number is 91-0654879. Thank You, Jack Hughes DISCOUNT FIREWORKS SPECIALTY LEASE AGREEMENT THIS LEASE made and entered into as of the Date of Lease, by and between THE MARKETS LLC, doing business as ARLINGTON FOOD PAVILION and JACK HUGHES, doing business as J & M L.L.C. The following-is agreed upon between THE MARKETS LLC, doing - business as ARLINGTON FOOD PAVILION and Jack Hughes: A: Date of Lease of space in parking lot: June 17, 2013 to July 10, 2013. Firework stand will be placed in store parking lot by J&M LLC in location approved by store manager. Will be operated by non-profit organization. B: Certificates of insurance included with lease agreement listing THE MARKETS LLC, doing business as ARLINGTON FOOD PAVILION, as additional insured with liability $500,000.00 per each occurrence and $3,000,000.00 general aggregate. C: THE MARKETS LLC is not liable for fireworks stand or merchandise inside fireworks stand located at: THE MARKETS LLC, dba ARLINGTON FOOD PAVILION ARLINGTON, WA J & M L.L.C. assumes all responsibility for personal property and merchandise. D: Rent for 25 days: $1500.00 E: Surrounding area of firework stand to be kept free of debris during 25 days of operation. F: If the sale of fireworks is banned by the State of Washington or by the City of Arlington, this lease is void. DATE: 7 I n SETS LL AC HU ES ` ✓� J&M L.L.C. 1 ti i e ,+ o IN rt - I c RECEIVED MAY 0 r) 2013 COA En,,-,, . mng Dept. qk I �„ Permit#: 93 Permit Date: 05/06/13 Permit Type: TEMPORARY STRUCTURE Project Name: Discount Fireworks Applicant Name: Applicant Address: Applicant, City, State, Zip: Contact: Phone: 509-322-5618 Email: Scope of Work: Fireworks Stand Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Launa Black Property Parcel# Address Legal Description Owner Name Owner Phone Zoning SHOPPING 00461803000100 146 HALLER AVE CENTER PROP OF or Groceries(With Without Meat) ARLINGTON LLC or Contractors Contractor Primary Contact Phone Address Contractor Type License License J&M,LLC dba Discount Fireworks Jack Hughes 509-322-5618 P.O.Box 1463 OWNER Plan Reviews Date Review Type Description Assigned To Review Status 05/06/2013 OPERATING permit tracking Launa Black 05/06/2013 OPERATING No issues.O.P.can be issued. z.Christopher Young 05/06/2013 OPERATING fireworks z.Tom Cooper Attached Letters Date Letter Description 05/06/2013 Building Permit Uploaded Files Date File Name 05/08/2013 146 Haller O.P..docx 05/06/2013 BLD 93.pdf