HomeMy WebLinkAboutHAZ COND PERM APP, INSPINSPECTIONS
(FIRE SAFETY INSPECTIONS)
HAZARDOUS CONDITIONS PERMIT APPLICATION
,I
B nrN T
PERMIT: #
BAKERSFIELD FIRE DEPT.
PREVENTION SERVICES
1501 Truxtun Ave.
Bakersfield, CA 93301
Tel: (661) 326 -3979
Fax: (661) 852 -2171
Page of 11111111111111111111 41
1
In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made by:
I IA
Name of Company Address City, Stat6, Zip
Contact Name Phone No. Ce 1-
To display, store, install, use, operate, sell or handle materials or processes involving or creating
conditions deemed hazardous to life or property as follows:
FD 2039
A PERMIT WAS ssued on l O `91- 1 1)
0 Denied Date
X
Auth zed Representative of
C pa Requesting Inspection
By:
Inspecting Olf`Hc1 {er/Fire Marshal
�" White Copy to File Card Copy to Permittee for Display 111131 I,��""` 42
IE
TENTS
ALL OTHER PERMITS See attachments
LOC4APN OF INSTALLATI N:
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EVENT DATE & PURPOSE:
10 -a - l Q -t�, - -
SET UP:
TAKE DOWN:
READY FOR INSPECTION:
AFTER HOURS I WEEKENDS
NU TENTS:
SIZE:
N R OF TENTS:
SIZE:
PYRO TECH NAME:
YRO TECH PHONE #:
PYRO LIC i
FD 2039
A PERMIT WAS ssued on l O `91- 1 1)
0 Denied Date
X
Auth zed Representative of
C pa Requesting Inspection
By:
Inspecting Olf`Hc1 {er/Fire Marshal
�" White Copy to File Card Copy to Permittee for Display 111131 I,��""` 42
IE
City of-Me'rsfield
+ CLSTOiER EMU **4
Oper: TUANF0M Type: OC drawer: 1
}ate: 10/28/401 Receipt no: '42554
Description Quantityy Aeount
84 FR SAFETY iNSFECTIONS
1.00 $606.00
ender detail
CK MIX 8P, 0 $605.00
Total tendered- If4b.N
Total payaent 1605.00
Trans date: 10129/10 Tim 9 :26 :25
iELP CONTROL THE PET POPULATION
PL AE SPAY OR NEUTER
RABOBANK ARENA THEATER & CONVENTION CENTER
BAKERSFIELD FIRE DEP
Item to be Paid - Description
Check Number: 8 57 0
Check Date: Oct 20, 2010
Check Amount: $605.00
Discount Taken Amount Paid
102010 605.00
8570
IdFICEP
A=5�
STATEIFIRE MARSHAL
CALIFORNIA DEPARTMENT OF IrORESTRY and TIRE PROTECTION
OFFICE OF THE STATE FIRE MARSHAL
FIREWORKS LICENSE
License Type: GPD -0520 Issue Date: 04/29/2010
Licenses: RMGLING BR/B &B CONNED SHOWS
ATTN: JEROM33 SOWALSKY
8607 WESTWOOD CENTER DR.
VIENNA, VA 22182 -0000
The named licensee is authorized to perform atl acts permitted a fireworks
PUBLIC DISPLAY (GENERAL)
pursuant to Part. II, Chapter I of the Health and Safety Code of the State of California.
Expires: 6/30/2011
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STA
CALIFORNIA DEPARTMENT OF FORESTRY and FIRE PROTECTION
OFFICE OF THE STATE FIRE MARSMM
FIREWORKS LICENSE
License Type: W -1199 Issue Date: 04/29/2010
Licensee: ULTRATEC SPECIAL EFFECTS INC
ATTN: ADRIAN SEGEREN
148 MOON DRIVE
OWENS CROSSROADS, AL 35763
The named licensee is authorized to perform all acts permitted a fireworks
WHOLESALER
pursuant to Part II, Chapter I of the Health and Safety Code of the State of California.
Expires: 6/30/2011
Deputy State Fire Marshal
F'a- 161C,; - La - 011
Pot-
STATEIFIRE MARSHAL
CALIFORNIA DEPARTMENT OF FORESTRY and FIRE PROTECTION
. . OFFICE OF THE, STATE FIRE MARSHAL.
FIREWORKS LICENSE
License Type: I/E -1198 Issue Date: 04/29/2010
Licensee: ULTRATEC SPECIAL EFFECTS INC
ATTN: ADRIAN SEGEREN
148 LOON DRIVE
OWENS CROSS ROADS, AL 35763
'The named licensee is authorized to perform all acts permitted a fireworks
IMPORTER/EXPORTER
pursuant to Part I1, Chapter I of the Health and Safety Code of the State of California.
Expires: 6/30/2011
/ Deputy State 1'i-re Marshal.
SHOW SCHEDULE
Engagement Information
Let's Celebrate! - 2010 -2011 Rabobank Arena
1001 Truxtun Ave.
Bakersfield, CA (9)
10/21/2010 - 10/24/2010
(661) 852 -7300 (661) 852 -7300.
Performance Schedule
Bakersfield, CA 93301
Date
Morning
Afternoon
Afternoon
Evening
Thu
(1)
10/21/10
:00 PM
Fri
(2)
10/22/10
:00 PM
Sat
(3)
(4)
(5)
10/23/10
11:00 AM
:00 PM
:00 PM
Sun
(6)
(7)
10/24/10
1:00 PM
:00 PM
Show in red (if any) are not confirmed or are shows with no public ticket sales
rl::ctNr
CORD. CERTIFICATE OF LIABILITY INSURANCE VA
CORD. ,4 9a� 1 !2t010
PRDCUCdR
Wei% Fargo Insuraroa- SerAces USA, Inc
1401 H S=reet, K%Y , Suite 75D
WashtngtorE DC 20005
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER_ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED E Y THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
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8503 Westwocid Center Drt%,e
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AMY REQUIREMENT, TOM OR 00NOCTgN OF MY CONTRAZ7 OR OTHER 00CUL(ENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
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ultratec
special effects inc- Packaging Work Sheet
Part Number FELD 2
FIRE 20
Show Name Celebrations! - D30
Per Show Total Demo Total Set
oty Show Qty Qty Qty Cue # Location Part #
Description
QTY�i
NEQ per Total
Device NEQ
2
2
1
3
1
Halloween Gate
CPPAF2553
AF 25' Orange Ca less Star Mines w/Tail
8
24
2
2
1
3
2
Fairy Godmother
CPP- MN25SS
25' Silver Strobe Mine
10
30
1
1
1
2
6
Fountain
CPP- MN25GS
25' Gold Strobe Mine
10
20
4
1
5
3.6.8
Minnieffinkerbelle Entr & Fountain
CPP- AF4070
AF 25' Star Mine White Snowball w/tail LMH
8
40
1
9
11
Finale
CPPAF2556
AF 25' Red Ca less Star Mines w/Tail
8
72
2
2
11
3
1
4&0
Fairy Godmother & Tinkerbelle wand
CPP- GB1220S
Gerb 112 x 20 Silver LMH Coiled `S
1.3
3.9
4
1
5
10
Finale
CPPGB1020S
10 x 20 Silver Gerb LMH with match
15
75
8
8
1
9
11
Finale
CPPAF2552
AF 25' Ca less Star Mines w/Tail - Green
8
72
81
8
1
9
12
Finale
CPPGBO125S
1 X 25 Silver Gerb LMH
1.3
11.7
11
1
0
1
7
Torch, Fire baton, ice
CLPHF001
Hydro Fire -by gallon
0
0
11
1
0
11
1
7
Torch, Fire baton, ice
FLM1206
Red Fire Storm Fluid- by liter
01
0
Total NEQ
NEQ is measured in grams 348.6
Disney Celebrations
P'yro Ust & Running Times
Cue Time Description
1 0:20:00 HALLOWEEN GATE —Jack Skellington entrance
30' to 35" from audience
2 0:33:00 FAIRY GODMOTHER - Entrance
25' to 30' from audience
3 PRINCESS MINNIE ENTRANCE
25' to 30' from audience
4 0:47:00 FAIRYGODMOTHER WAND - Handheld device
20' to 25' from audience
5 & 6 0:51:00 FOUNTAIN
30' to 35" from audience
Intermission
Qty Description
2 AF 25ft Orange Mine w/Tail
From Halloween Gate Prop in front of stage /set
2 Mine 25ft Silver Strobe
From second level stage /set
1 AF 25' Snowball
From second level stage /set
1 1/2 x 20 Gerb
Handheld Device
1 Mine 25ft Gold Strobe - Top Ring of Fountain
2 AF 25ft Snowball Mine w/Tail - Bottom Ring
From Prop on Center lee
7 0:02:00 TORCH, FIRE BATON, ICE FIRE -This is aflame effect 1 Hydro Flame - Ice Fire
30, to 3S "from audience 1 Firestrom Fluid - Fire Pit & Torches
See Flame Effect Diagram
8 0:34:00 Tinker Entrance
25'to 30' from audience
9 0:35:00 Tinkerbelle's Wand - Handheld device
2S' to 20' from audience
10 0 :37:00 FINALE
20'to 25' from audience
11 0:37:00 FINALE
20' to 25' from audience
12 0:37:00 FINALE
30' to 35" from audience
1 AF 25' Snowball
From second level stage /set
1 1/2 x 20 Gerb
Handheld Device
4 10 x 20 Gerb
From Truss Legs
16 Starmines, 8 red & 8 green
From Truss Legs
8 Gerb 1 x 25
From center of Truss
RUNNING TIMES ARE APPROXIMATE
The Truss is hung
from ceiling; all
Pyro pieces shown
as ON the truss
will fire hung from
truss. All other
Pyro pieces will be
shot from props
on the ice floor.
Disney Celebrations Detonation Plot
There will be no effect closer than 15' from the audience.
1't half Effects
TRUSS BEAM 1
Effect # 2: [2] Mines, 25'
Silver Strobes shot from
second level stage, shot up
STAGE SET SECOND LEVEL %' anti niawwd
Effect #3: [1] 25'
_ Snowball Starmine
A A" _ _ • — • ~ • — shot from second
level stage, shot up
and outward ,
toward center ice.
Effect #5 & 6: [1125' E Effect #1: 12125' AF
Mine, Gold Strobe, N a, Orange Mines shot
from top ring of T from top of
Water Fountain prop Halloween Gate
& [2] 25' Snowball E prop Approx 8' off
Starmine w /tail from _ R Ice, shot up and
bottom ring. � outward
TRUSS BEAM 2
Effect #4: [1] Y� x 20 Gerb shot
from hand held device (Fairy
Godmother wand) from Ice
floor
Intermission
This is 1 of 2
barrels that are
used to place the
Tiki Torches
after the skaters
perform their
routine.
Disney Celebrations Flame Effect Plot
There will be no effect closer than 15' from the audience.
TRUSS BEAM 1
2nd half Effects
STAGE SET
Effect #7: There
� will be [1] Flame
SECOND LEVEL '� Pit placed here,
fueled with
A Firestorm Fluid;
Tiki torches are lit
from here.
C
E There is NO
N flame in this
T /area in redl
E j
TRUSS BEAM 2 R.
This is 1 of 2 barrels
that are used to place
the tiki torches after the
skaters perform their
routine.
Effect #7: Hydro
j Flame gel fuel will be
Effect: 7
— applied to the ice
Flame is lit here and then lit by a
from this + • . _ • — performer with a
position and baton that is already
last approx 5 Effect #7: This is a on fire
seconds Baton held by
Performer; it is lit
on both ends.
TRUSS BEAM 3
I
Effect #7 is a flame effect. 1st the flame pit will be brought out and lit then 10 skaters holding tiki torches will
come onto the ice and their torches lit by the flame pit, another skater will come out carrying a baton which will also
be lit. The skaters will perform a short routine while a skater applies the fuel to the ice; on cue the skater with the
baton will light the ice on fire. The flame will last approx 15 seconds and burn out. While the flame effect is on the
ice the other skaters will place their torches in one of the 2 Barrels on the ice; the baton will be put into a snuff box.
The Truss is hung
from ceiling; all Pyro
pieces shown as ON
the truss will fire
hung from truss. All
other Pyro pieces
will be shot from
props on the ice
Effect #10: [41 10 x
20' Gerbs shot
from end truss
legs that come
down towards ice
Effect #12: [8] 1x25'
Gerbs, shot from a
device attached to
the Center Beam
Truss.
Disney Celebrations Detonation Plot
There will be no effect closer than 15' from the audience.
2nd half Effects
STAGE SET
SECOND LEVEL
TRUSS BEAM 1
N
T
E
R_.. —..—
.
\•
/
TRUSS BEAM'
\\
"rte
,�
i '
/
�
� � • •
B
TRUSS
BEAM 3
E
A.... ...
M
Effect #8: [1] 25'
Silver Snowball
Mine shot from
Stage entrance
approx 10' off the
Ice, up and
outward. This is
Tinkerbelle's
Effect: 11 [16]
Starmines, 8 red
& 8 green from
end of truss legs
that come down
towards ice; 1
red & 1 green at
each *.
Effect #9: This is a
Y. x 20 Gerb shot
from a handheld
/ device towards the
center by
Tinkerbelle.
*Effect #10,11 & 12 is the finale and all effects will go off within a fraction of a second of each other,
the 10 x 20' Gerbs will fire for up to 10 seconds.
Pyrotechnician History Report
Permanent Address:
Chris Lamb
1313 17th Street East
Palmetto, FL 34221
Experience:
2010 - Current Pyrotechnic Shooter, Disney's Celebrations
Summary:
- Chris Lamb has been employed by Feld Entertainment, Inc. DBA 100 Years
of Disney Magic as the shows Asst Pyrotechnic shooter since 2004.
- He has successfully completed an in house pyrotechnic training course
by the shows pyrotechnic shooter /electrician.
- Since he completed his training he has been loading /firing /unloading/
the show under the supervision and guidance of a Licensed
Pyrotechnician..
- The training he has received includes: a Pyro safety course, and the
safe use of pyrotechnics in the performing arts before a proximate
audience, performers or support personnel using the NFPA -1126 as a
standard.
- Chris Lamb has shot over 50 shows without incident.
Oklahoma State Drivers' license:
(Image may not be visible if faxed)
Name: Lamb, Christopher, D.
DL #: R081962405
Exp: 1/31/2012
DOB: 6/19/88
Ht: 6'01"
Wt: 140
Eyes: Brown
Hair: Black
Sex: Male
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Pyrotechnician History Report,
Permanent Address:
Ben Jobe
131317 th Street East
Palmetto, FL 34221
Experience:
2008 — Current Pyrotechnic Shooter, Disney's, Celebrations
Summary:
- Ben Jobe was employed by Feld Entertainment, Inc. DBA Disney's on Ice, first as the shows Asst. Pyrotechnic
shooter and is now the Lead Pyrotechnic Shooter.
- He has successfully completed an in house pyrotechnic training course by the shows pyrotechnic
shooter /electrician. Since he completed his training he has been loading/firing /unloading the shows
pyrotechnics.
- The training he has received includes: a Pyro safety course, and the safe use of pyrotechnics in the
performing arts before a proximate audience, performers or support personnel using the NFPA -1126 as a
standard.
- Ben has loaded and /or shot over 100+ shows without incident.
Indiana State Drivers' license:
(Image may not be visible if faxed)
Name: Jobe, Ben A.
Lic #: 0220 -15 -7839
DOB: 9/14/1980
Ht: 5'6"
Wt: 190
Eyes: Hazel
Hair: Brown
Sex: Male
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Pyrotechnician History Report
Permanent Address:
Lani L. Nilsson
1313 17`h Street East
Palmetto, FL 34233
Related Experience:
1999 - 2009: Electrician and Pyrotechnician, 100 Years of Disney.
2009 - Current Electrician and Back -up Pyrotechnician, Disney's,
Celebrations
Summary:
- Lani Nilsson began her career in 1999 as Electrician /Pyrotechnic
Shooter on, 100 Years of Disney Magic and currently as an Electrician and
Back -up Pyrotechnician
- Lani has completed a pyrotechnic safety class and is fully trained
on the loading, shooting and disposal of pyrotechnics used in this
Performance.
- The training she has received includes: a pyrotechnic safety
course, and the safe use of pyrotechnics in the performing arts before
a.proximate audience, performers or support personnel using the
NFPA -1126 as a standard.
- During her career with Disney on Ice Lani Nilsson has shot over 1000+
shows without incident. (See Florida and Georgia Pyrotechnic Operators
licenses next page).
Hawaii State Drivers' license:
(Image may not be visible if faxed)
Name: Nilsson, Lani Lein
DL #: H001163682
Exp: 06/03/2012
DOB: 06/03/1975
Ht: 5'10"
Wt: 145
Eyes: Blue
Hair: Brown
Sex: Female
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Pyrotechnician History Report
Permanent Address:
Daniel Benavides
1313 17th Street East
Palmetto, FL 34221
Experience:
2008 - Current Pyrotechnic Shooter, Disney on Ice, Celebrations
Summary:
- Daniel was employed in 2008 by Feld Entertainment,
Inc. DBA Disney on Ice,. a Celebrations, as the shows Asst.
Pyrotechnic shooter.
- He has successfully completed an in house pyrotechnic training course
by the shows pyrotechnic shooter /electrician. Since she completed her
training she has been loading /firing /unloading the shows pyrotechnics.
- The training she has received includes: a Pyro safety course, and the
safe use of pyrotechnics in the performing arts before a proximate
audience, performers or support personnel using the NFPA -1126 as a
standard.
- Daniel Benavides has loaded and /or shot over 300 shows without
incident.
Texas state drivers license:
(May not be legible if faxed)
Name: Benavides, Daniel B
DL#: 12170724
DOB: 2/25/86
Ht: 6'2"
Wt: 190
Eyes: Brown
Hair: Black
Sex: Male
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NAME Chris Gopher Lemb
ADDRESS 1 D12 Hazel Court
CITY
SSN 430 --74 -5464
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BACK -UP SHOOTER /ASSISTANT:
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