17-104115 4101
" RECEIVE PERMIT APPLICATION
Federal Iav
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
AUG ,e ��1� 253-835-2607+ FAX 253-835-2609 +permitcenter(a�cityoffederalway.com
0l JOF FEDEFA.L
PERMIT NUMBER I 1 _ I OMN�T�r DE\!ELO� lEti'i e. -PN 1
I — — TARGET DATE /
SITE ADDRESS SUITE/UNIT#
2505 S 320th st, Federal Way, WA, 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 11, 459 . 12 CC-C 7 9 7 8 2 0 - 0 5 3 5
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING a FIRE PREVENTION
NAME OF PROJECT Federal Way Center TI
Add sprinkler as required for new ceilings and walls .
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PRIMARY PHONE
DM VENTURES FW CENTER LLC
PROPERTY OWNER MAILING ADDRESS E-MAIL
6725 116TH AVE NE STE 100
CITY STATE 'ZIP
Kirkland WA 980338455
NAME PHONE
Archer Construction 253-872-7222
MAILING ADDRESS E-MAIL
7855 SO 206th St permits@archerconstruction.com
CONTRACTOR
CITY STATE ZIP FAX
Kent Wa 98032 253-872-7277
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
CC ARCHEI*219DR 04 01 /2019 20-00-101463-00-BL
NAME PRIMARY PHONE
Archer Construction 253-872-7222
APPLICANT MAILING ADDRESS E-MAIL
7855 SO 206th St permits@archerconstruction.com
CITY STATE ZIP FAX
Kent Wa 98032 253-872-7277
NAME PRIMARY PHONE
PROJECT CONTACT Oleg Sergeev 253-872-7222
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
7855 SO 206th S t permits@archerconstruction.com
concerning this application) CITYSTATE ZIP FAX
Kent Wa 98032 253-872-7277
NAME
PROJECT FINANCING 0 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 authorized 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 authorised 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: �mn¶ v_6\\0 DATE 08/24/2017
r
PRINT NAME: Kenneth Kolbe
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application