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Home My WebLink AboutCLE201900088 Approval - Agencies 2019-06-17AMIRwIffz ALBEA/lARLE COUNTY www.AEFireRescue.org FIRE PREVENTION PERMIT APPLICATION — TENT Applicant/Responsible Party (Billing Contact) Applicant Name & Email: KC Meyercord kendallm@hq.kappasigma.org Contact Name & Email: KC Meyercord kendallm@hq.kappasigma.org Mailing Address: 1610 Scottsville Rd City, State, Zip: Charlottesville, VA 22902 Telephone: (Day) 4342953193 (Cell) 2148032274 Date of Event: July 26, 2019 Time of Event: 5:00 PM - 10:00 PM Date Requested for Fire Marshal Inspection: July 24, 2019 Time Requested: 8:00 AM Address of Event: 1610 Scottsville Rd Name of Facility: Kappa Sigma Fraternity Headquarters Event Coordinator (Fill in "NIA "if not applicable) Business Name: N/A Contact Name: Telephone: (Day) (Cell) Tent Company Business Name: Skyline Contact Name: Kathryn Kieffer Telephone: (Day) 434.977.8368 (Cell) 434.484.0140 Date & Time Tent Is To Be Erected: July 23, 2019 - All Day Caterer (Fill in "NIA "if not applicable) Contact Name: Virginia Catering Company - Scott Stroney Telephone: (Day) 434-924-7234 (Cell) 434-825-6639 Time Caterer Will Be Ready for Floor Layout Inspection: TBD * See reverse (page 2) for Conditions & Acknowledgements (Page 1 of 2) OFFICE USE: Fee: Check: Credit Card: Cash: Receipt: CONDITIONS & ACKNOWLEDGEMENTS The applicant is required to review and initial the following requirements. By initialing each item, the applicant acknowledges their review and agreement to comply with any listed requirements as expressed by the Albemarle County Office of the Fire Marshal. 1. MBW A COMPLETE application packet must be submitted prior to event. After receipt of complete packet, an inspection date/time may then be scheduled. (Any section that is "not applicable" should be indicated as such.) 2. MBW Permit fees are based on the following: • $100 if complete application is received 30+days prior to event • $150 if complete application is received 15-29 days prior to event • $200 if complete application is received 8-15 days prior to event • $300 if complete application is received less than 7 days prior to event 3. MBW Set-up of the tent/s, including tables, chairs, etc., will need to be COMPLETE before a fire marshal inspection can take place, and a representative of the applicant needs to be present for the inspection. 4. MBW A copy of the following documents are attached: a. MBW Site Plan b. MBW Flame Resistant Certificate(s) C. MBW Tent Content Layout (including scale in accordance with Code Compliance Guideline & Checklist) 5. The following Albemarle County Community Development Department permit applications or approvals or documentation that they are not needed are attached: a. MBW Building Permit b. MBW Zoning Special Use Permit 6. MBW No open flames, candles, devices emitting flame or heat or any flammable or combustible liquids, gas, charcoal, or other cooking device will be utilized without prior approval. 7. MBW Request for the use of open flames, candles, devices emitting flame or heat or cooking devices and accompanying documentation are attached. 8. MBWAII conditions and requirements are to be in accordance with Virginia Statewide Fire Prevention Code and the Fire Prevention Code of Albemarle County pertaining to the above application. 9. MBW Final approval is based upon plan review and Fire Marshal inspection upon setup the day of the event. By my signature below, I attest the above information is accurate and correct. I acknowledge and agree to comply with all applicable federal/state/local laws, codes, ordinances, rules and regulations including but not limited to the requirements of the Virginia Statewide Fire Prevention Code and the Code of Albemarle County and its referenced standards even those not specifically expressed on this application. I also acknowledge that if a permit is issued based upon this application, it shall be valid only at the location listed on the application and for the specific dates(s) and time(s) for which it is issued. If approved for permit issuance, I acknowledge that a copy of this application and all its attachments will be available on -site during the dates and times noted. I further acknowledge and understand that any violations identified after permit issuance may result in immediate permit suspension, revocation, or up to and including criminal charges. Signature & Printed Name of Applicant Mitchell B. Wilson 4/17/19 (Page 2 of 2) Date _� I _ii J.• • Rt ��'.�'S i .� s 40'-0" 0 0 00 Kappa Sig 1610 Scottsville Road 07/2 7/2019 Equipment Shown: (1) 40x80 Frame Tent (24) 5' Rounds (240) Chairs 80'-0" Kappa Sigma 1610 Scottsville Road Equipment Shown: (1) 60x80 Pole Tent (1) 12x20 Stage (44) 8x30Tables Skyline TLM COMPNJY IMPORTANT DOCUMENT Certificate of E&me Wssistance ISSUED BY Date of Shipment 6/252014 Registration Number �USTnOR® Sales Order# F-140.01 US SO-605971 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: 76636 SKYLINE TENT COMPANY INC (B) (S-82280) 1327 CARLTON AVE CHARLOTTESVILLE VA 22902 USA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial # 8001802 (1) Description of item certified: FIESTA TOP 20WX30 WHITE SNYDER Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING INC PHILADELPHIA PA Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC InrPrPd�--P,rP�P-','Pd'�P',IMPORTANT DOCUMENTu�'rs�t"rrrd�"��'u�'u� Certificate of Flange Resistance REGISTRATION ISSUED BY Date 0f Shipment APPLICATION a CN�R. srz9,2006 NUMBER ,c"°os*aie i"c /.� EVANSVILLE, INDIANA 47725 Tent Identification P UO.I ' MANUFACTURERS OF THE FINISHED 0,215111 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: 76636 SKYLINE TENT COMPANY INC 912 LOCUST AVE CHARLOTTESVILLE VA22901 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. Serial* 80470W(2) Description of Item certified: NAVITR.SC END 40W 20 SNYDER WHITE VNYI. Flame Retardant Process Used Will Not tie Hemovea by Washing And Is Effective For The Life Of The Fabric SNYDER MFG NEW PHILADELPHLIOH Signed: ' 'SPECIAL EVENTS DIVISION . ANCHOP INDUSTRIES INC. IMPORTANT DOCUMENT Certificate of EFlame W§sistance ISSUED BY Date of Shipment 3/10/2016 Registration Number I�TWO YRIEYINme! r; Sales Order# F-140.01 t1i SO-627944 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: 76636 SKYLINE TENT COMPANY INC (B) (S-82280) 1327 CARLTON AVE Charlottesville VA 22902 USA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial # 8151210 (1) Description of item certified: CENTURY END 60W X 20 HOLE SNYDER WHITE VINYL 10' SPACING Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric �i SNYDER MANUFACTURING INC PHILADELPHIA OH Lel,/., �, 16.,��..j Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC to JI1i73"e�1111i916 111 1_9M Certificate of F&me lssistance ISSUED BY 3/1=0e of Shipment 110Y216 Registration Number i INDCC UST INC.® Sales Order# F-140.01 SO-627944 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently Flame retardant and were supplied to: 76636 SKYLINE TENT COMPANY INC (B) (S-82280) 1327 CARLTON AVE Charlottesville VA 22902 USA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial # 8151110 (2) Description of item certified: CENTURY MIDDLE 60W X 30 SNYDER WHITE VINYL 10' SPACING Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING INC PHILADELPHIA OH Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC 4/17/2019 Centralized Payments � Your Payment Was Submitted Transaction ID: 45V269763E497873W Transaction 04/17/2019 04:53 Time: PM Total Paid: $102.87 We will receive notification of your online payment at the time that it is made and we will credit your payment as of that day. However, you will not see the payment on your account for approximately 48-72 hours due to the time that it takes to get those funds into our bank account. Item Amount Website Payment $100.00 Item Number: 9CDB43 Type: Fire and Rescue Permits Notes: Tent Permit Application - More than 30 Days Out - Kappa Sigma Fraternity - 1610 Scottsville Rd Transaction Fee $2.87 Total $102.87 https://www.albemarlecountytaxes.org/default.aspx?pageID=l10&mp=Master.Master&token=EC-9N798100YT549173C&PayerID=YQ8F9FMLTVDRE 1/1