19-105836 A
RECEIVE® PERMIT APPLICATION
CITY OF
Federal Way DEC 16 2019 PERMIT CENTER+33325 8,h Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcenter(itcitvoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER ' _ 0 5 8 3 _ 1 TARGET DATE
PiPr
SITE ADDRESS SUITE/UNIT N
Safeway Fuel Center#1555: 1207 S 320th Street, Federal Way, WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N
$ 1,000.00 CC-F 1 5 0 0 5 0 - 0 0 2 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING iI FIRE PREVENTION
NAME OF PROJECT LPG @ Safeway FC#1555
Installation of (1) 18-count propane cylinder exchange cage for resale. Cage holds 18
PROJECT DESCRIPTION
Detailed description of work to cylinders at 20#each, 360#in total. Cylinders will be kept in a lockable, ventilated cabinet
be included on this permit only of metal construction. There is no dispensing of propane. Cage is 3'W x 4'L x 6'H.
NAME MGP IX Sunset Square LLC PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS E-MAIL
425 California Street, 11th Floor
CITY
1 San Francisco SCA ZIP 94104
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE A EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE X
NAME Rachel Orlando on behalf of AmeriGas Propane PRIMARY610)768-3858
APPLICANT MAILING ADDRESS E-1150 First Avenue, Suite 500 Rachel. Orlando@amerigas.com
CITY King of Prussia STPZIP 19406 FAX (610) 768-7696
PRIMPROJECT CONTACT PHONE
NAME Rachel Orlando on behalf of AmeriGas Propane
�(610)768-3858
E-(The individual to receive and MAILING ADDRESS 1150 First Avenue, Suite 500 Rachel.Orlando@amerigas.com
respond to all correspondence
concerning this application) CITY King of Prussia STATE ZIP
PA 19406 FAX
610 768-7696
)
NAME
PROJECT FINANCING ❑ OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied
/to the city as a part of this application.
SIGNATURE: • a+�is. /ars DATE 12/13/2019
PRINT NAME: Rachel Orlando
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application