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540 West Ave_PJ25-0126_2026
CONSTRUCTION PERMIT APPLICATION Community and Economic Development City of Arlington • 18204 59th Avenue NE • Arlington,WA 98223 • Phone(360)403-3551 CIVIL(TYPE I) 13 GRADING/PAVING/DRAINAGE(TYPE II) RIGHT OF WAY(TYPE III) TYPE 1&II ONLY NEW DEVELOPMENT REDEVELOPMENT Project Name: 61,1H cAgl(A'A'K+ 5clucA'rC --V'J Al I-9- -.j0(k`:� R? 12c6r Project Address/Location: .W t-,,a Aje,� Adinr,hA Tax Parcel I.D.#: Description of Project: 5°�e,'\.laJ� Lei2f r1,264 Project Size in Acres: DOE General Construction Stormwater Permit#: OWNER Name: Dale, 5 k in Address: 5L- `,,✓r Ci rr •f\q Of\ State: Zip: r zZ 3 Phone: L12 5 '2-7�q F--K) Email: 64" d JS 10 d 0 APPLICANT Name: Tract-lG ' Ro A r , Address: 12L' C( r� =yQf1c PCn Ci � r State: W A Zip: 41` 0 r6 Phone: GtZt� ��jU' ��y�dc� Email: 1 r" 1�✓MGti( � in (,C) ENGINEER*t Name: IV /A Address: N/f k City: J V 1A State: Zip: Phone: Email: License#: N A Expiration: N//A CONTRACTOR ,l Name: �v1( �5 C�r1s��G'G `rQo LLt Address: e Q,er(4 f k city: (� (w'i 0d State: \,.I A Zip: q�o Phone: �1 Z r C1' f zz Email: SMGz 1r., i • ( 0 License#T5'rnA • ' ?0t /� Expiration: I, hereby certify that 1 have read and examined this application, City of Arlington Municipal Code, Standard Plan &Specifications. Performance of the proposed work shall follow all applicable laws and regulations.The owner/applicant shall assume full and complete responsibility for said work and shall be responsible for the acquisition and compliance of all applicable permits and/or authorizations which may include,but not limited to, Right of Way Permit,WSDW Hydraulic Project Approval(HPA),WSDOE Notice of Intent(NOI),National Pollutant Discharge Elimination System(NPDES),Army Corp.of Engineers Permits,the�requ' ements l tffe—Endangered Species Act,and the Forest Practices Application(FPA). Signature ,1W, Print Name: Date: !Z' Page 1 of 2 REV2/2024 12/17/25,4:42 PM Sidewalk closure Permit-Kristin Foster-Outlook 9� ®�� , ,ll3 (•I�k io.Inia) U9 y� o e - Set-Sidewalk Direct Pedestrian's across street �---- x W close sign LOC ..-,y} LIS'on St E- siono.Sf r!ns t� J A" r. t Dail , p Se Pdrk b529900900101 t r m i a T �•- s �.. —._.r=1-1" -'"gym —0400 M. �.. 00619100100600 E oa.z99o1oo soD �20 T -(amply pS 990 yDDA ' t O �r _j yp oo, set Sidewalk I Dofiiemoloonpo ,�• , 1 !— Z" close-sign DVDo - oss o,owao el LOC © 0051990,00,502 pip. �. 1- 1 516 515 1 51 509 ^.,; .9D�Y 112 ' 005199010p1501 5D 1 0 0 O0- Mo o0fi1610010p900 ' Direct Pedestnans to �� - I' - ' oosz 9oioDldoo other side of street. D Doss99p1p o900 n Pe.ces i 61a1oo,olgo� ?9 10or'-"�c orlifo) 001 ]00d00 "' 91 0p5 29 001]00 005I9901p 1 p 10�n Li 6.M µ. "-:.fie x o. F-• e � it a.w .. J........ - � ..n•.:---�.«. �� nes ssn about:blank?windowld=SecondaryReading Panel 1/1 City of Arlington 18204 59th Avenue NE, Arlington, • • Washington 98223 Phone: 360-403-3551 jNG� WASHINGTON C Invoice Number: 25-0153 INVOICE Invoice Date: December 30, 2025 Account Number: 1886186207 Bill To: Invoice Questions? Ismael Rodriquez Phone: 360-403-3551 12419 Beverly Park Rd Lynnwood, WA 98087 Email: ced@arlingtonwa.gov Invoice Due Date: December 30, 2023 Record Number: Project 25-0126 Parcel Number: 00618100200300 Location: 540 WEST AVE Date Description Paid Date Amount Paid Balance December 18, Right of Way(006.322.40.00.02) $150.00 2025 December 18, Processing/Technology Fee (320.341.43.00.02) $25.00 2025 TOTAL: Project Fees $175.00 $175.00 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------- REMITTANCE INFORMATION If you are paying by check, please include this portion with your payment and remit to the address listed on this invoice. Remittance Information Invoice Account Total Due Your payment is due by December 30, 2025 Number Number This Invoice 25-0153 1886186207 J$175.00 Ismael Rodriquez 12419 Beverly Park Rd Lynnwood, WA 98087 18204 59th Avenue NE • ' • 14 op Arlington, Washington 98223 to tt Phone: 360-403-3551 jNG� WASHINGTON C Civil Use - Right of Way Permit Parcel:00618100200300 Permit#:25-0126 Permit Address:540 WEST AVE Permit Expiration: Description of Work:Sidewalk panel replacement OWNER APPLICANT CONTRACTOR STILLAGUAMISH SQUARE LLP Ismael Rodriquez Ismael's Construction LLC 540 WEST AVE ARLINGTON,WA,98223 12419 Beverly Park Rd,Lynnwood,WA 98087 12419 Beverly Park,Lynnw000d,WA 98087 425-239-5074 425-740-4809 425 770 1722 dale.dusking@me.com it@ismaelsinc.com ismaels@ismaelsinc.com registration_number:602 991 617 PERMIT APPROVAL The issuance or granting of this permit shall not be construed to be a permit for, or approval of, any violation of this Code or any other ordinance or order of the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this jurisdiction or any other ordinance or executive order of the City, or of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect, inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or decision of the Governor. It is unlawful to use or occupy a building or structure until a final inspection has been made and approval or a Certificate of Occupancy has been granted. This permit authorizes only the work noted and covers work to be done on private property only. Any construction on public domain (curbs, sidewalks, driveways, marquees, etc.) will require a separate permit. The property owner shall ensure that the construction project complies with all applicable zoning codes and regulations. The property owner shall also ensure that the construction project does not cause any adverse impact on the surrounding environment or community. The property owner shall be responsible for obtaining all necessary permits and approvals from the relevant authorities before commencing construction. The property owner shall ensure that the construction project complies with all applicable design review requirements. CONDITIONS 1.) Replace sidewalk panel per detail R-170 Cement Concrete Sidewalk. Traffic Control must comply with the current version of MUTCD. Work Hours are 7 am to 7 pm Monday- Saturday (no work on Sundays or City Recognized Holidays). Inspections are not available on Saturday or 2.) Sunday. Non-motorized traffic control must be provided if any part of the work impacts existing non-motorized facilities. Non-motorized traffic control measures shall provide a level of accessibility that are, at minimum, equal to the existing conditions of the site. Two days before starting work, the applicant must have all utilities located. One Call, is a public utility locating 3.) service (#811 or 1-800-424-5555). Privately installed facilities must also be located using a private utility locating service. 4 ) Private property owners which may be affected by the proposed work must be notified in advance of potential disruptions in access or utility services. INSPECTIONS Inspection Line: 360-403-3417 Call for inspections by 3:30 pm for next day inspection. Please allow 48 hours for Fire Inspections. Please provide the following information when leaving a message: Permit Number, Type of Inspection, and provide preference of morning or afternoon inspection. Inspection Portal: Please login to customer portal and submit for the desired inspection type for the permit. APPROVED BY Admin - Thad Newport Development Services Engineering Manager ASSOCIATED FEES Date Description Paid Date Amount Paid Balance December 18, Right of Way(006.322.40.00.02) $150.00 2025 December 18, Processing/Technology Fee(320.341.43.00.02) $25.00 2025 TOTAL: Project Fees $175.00 $175.00 Credit/Debit Card 153 Payment Successful December 30, 2025 $175.00 $0.00 18204 59th Avenue NE • ' • 14 op Arlington, Washington 98223 to tt Phone: 360-403-3551 jNG� WASHINGTON C Civil Use - Right of Way Permit Parcel:00618100200300 Permit#:25-0126 Permit Address:540 WEST AVE Permit Expiration: Description of Work:Sidewalk panel replacement OWNER APPLICANT CONTRACTOR STILLAGUAMISH SQUARE LLP Ismael Rodriquez Ismael's Construction LLC 540 WEST AVE ARLINGTON,WA,98223 12419 Beverly Park Rd,Lynnwood,WA 98087 12419 Beverly Park,Lynnw000d,WA 98087 425-239-5074 425-740-4809 425 770 1722 dale.dusking@me.com it@ismaelsinc.com ismaels@ismaelsinc.com registration_number:602 991 617 PERMIT APPROVAL The issuance or granting of this permit shall not be construed to be a permit for, or approval of, any violation of this Code or any other ordinance or order of the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this jurisdiction or any other ordinance or executive order of the City, or of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect, inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or decision of the Governor. It is unlawful to use or occupy a building or structure until a final inspection has been made and approval or a Certificate of Occupancy has been granted. This permit authorizes only the work noted and covers work to be done on private property only. Any construction on public domain (curbs, sidewalks, driveways, marquees, etc.) will require a separate permit. The property owner shall ensure that the construction project complies with all applicable zoning codes and regulations. The property owner shall also ensure that the construction project does not cause any adverse impact on the surrounding environment or community. The property owner shall be responsible for obtaining all necessary permits and approvals from the relevant authorities before commencing construction. The property owner shall ensure that the construction project complies with all applicable design review requirements. CONDITIONS 1.) Replace sidewalk panel per detail R-170 Cement Concrete Sidewalk. Traffic Control must comply with the current version of MUTCD. Work Hours are 7 am to 7 pm Monday- Saturday (no work on Sundays or City Recognized Holidays). Inspections are not available on Saturday or 2.) Sunday. Non-motorized traffic control must be provided if any part of the work impacts existing non-motorized facilities. Non-motorized traffic control measures shall provide a level of accessibility that are, at minimum, equal to the existing conditions of the site. Two days before starting work, the applicant must have all utilities located. One Call, is a public utility locating 3.) service (#811 or 1-800-424-5555). Privately installed facilities must also be located using a private utility locating service. 4 ) Private property owners which may be affected by the proposed work must be notified in advance of potential disruptions in access or utility services. INSPECTIONS Inspection Line: 360-403-3417 Call for inspections by 3:30 pm for next day inspection. Please allow 48 hours for Fire Inspections. Please provide the following information when leaving a message: Permit Number, Type of Inspection, and provide preference of morning or afternoon inspection. Inspection Portal: Please login to customer portal and submit for the desired inspection type for the permit. APPROVED BY Admin - Thad Newport Development Services Engineering Manager ASSOCIATED FEES Date Description Paid Date Amount Paid Balance December 18, Right of Way(006.322.40.00.02) $150.00 2025 December 18, Processing/Technology Fee(320.341.43.00.02) $25.00 2025 TOTAL: Project Fees $175.00 $175.00 Credit/Debit Card 153 Payment Successful December 30, 2025 $175.00 $0.00 ISMACON-01 JSAINTDENIS '4coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/25/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jamie Saint-Denis NAME: Acrisure Northwest Partners Insurance Services,LLC PHONE FAX 19401 40th Ave W,Suite 440 (A/C,No,E:t):(425)712-0975 (A/C,No): Lynnwood,WA 98036 AoDRIE :JSaintDenis acrisure.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Middlesex Insurance Company 23434 INSURED INSURER B: Ismael's Construction INSURER C: 12419 Beverly Park Rd INSURER D: Lynnwood,WA 98087--1528 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN SD WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR A0271995 5/1/2025 5/1/2026 DAMAGE TO RENTED 500,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 MOTHER: L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY�X PROJEC LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO A0271995 5/1/2025 5/1/2026 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY Ix AUTOS BODILY INJURY Per accident $ X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE A0271995 5/1/2025 5/1/2026 AGGREGATE $ 2,000,000 DED I X I RETENTION$ 10,000 $ A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y A0271995 5/1/2025 5/1/2026 TAT TE ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N I A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 3,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Arlington are included as Additional Insured per attached form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Arlington THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y 9 ACCORDANCE WITH THE POLICY PROVISIONS. 238 N Olympic Ave Arlington,WA 98223 AUTHORIZED REPRESENTATIVE _ 7 _ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD tfi3 • r Google Maps • 1/2" x 4" FULL DEPTH EXPANSION JOINT EVERY 30'. ALIGN EXPANSION JOINTS & DUMMY JOINTS IN CURB V—GROOVE WITH JOINTS IN SIDEWALK 1/4" DEEP (TYP) V—GROOVE 1/4" DEEP (TYP) S 1/2"x 1-1/2" 6 o DUMMY JOINT ry 15 C/C 1/2" x 1 1/2" A DUMMY JOINT 15' C/C 1/2" x 1 1/2" FULL DEPTH CURB & GUTTER EXPANSION JOINT EVERY 30' PLAN VIEWS 5' TYPICAL 1/2" x 1 1/2" (SEE NOTE 7 BELOW) DUMMY JOINT 2% CEMENT CONCRETE SIDEWALK TYPE 1 CURB & GUTTER SEE STD DETAIL R-110 2" CRUSHED SURFACING \ �\ TOP COURSE, COMPACTED TO 95% DENSITY TYPICAL SECTION NOTES: 1. SIDEWALKS SHALL BE A MINIMUM OF 4" THICK, AND SHALL BE CLASS 3000 CEMENT CONCRETE, WITH AIR ENTRAINMENT (MIN 4.5% — MAX 6.5%). 2. FULL EXPANSION JOINTS SHALL GENERALLY BE PLACED TO MATCH THOSE PLACED IN ADJACENT CURB & GUTTER, WITH MAXIMUM SPACING OF 30 FEET, FINAL SPACING DETERMINATION SHALL BE DECIDED BY THE INSPECTOR IN THE FIELD. 3. SUBGRADE SHALL BE COMPACTED TO NOT LESS THAN 95% OF MAXIMUM DENSITY. 4. SIDEWALK SHALL BE AT LEAST 6" THICK IN DRIVEWAYS. 5. THE FINISHED SIDEWALK SHALL BE SPRAYED WITH A TRANSPARENT CURING COMPOUND COVERED BY WATERPROOF PAPER OR PLASTIC SHEETING IN THE EVENT OF RAIN OR OTHER INCLEMENT WEATHER. CURING TIME SHALL BE FOR A MINIMUM OF 72 HOURS. 6. ALL JOINTS SHALL BE CLEANED AND EDGED WITH AN EDGER HAVING A 1/4" RADIUS. 7. SIDEWALKS ARE TYPICALLY 5' WIDE, WIDER SIDEWALK MAY BE REQUIRED BY THE CITY. *IN APPROVED BY L OUVE DEPARTMENT OF PUBLIC WORKS STANDARD DETAIL DATE 07/31/2OOB STANDARD DETAILS NUMBER REF STD SPEC CEMENT CONCRETE SIDEWALK R- 1'70 4rtk( tot( WASHINGTON Project Information - ' 'nformat;^- Project # 25-0126 Parcel # 00618100200300 Building ID Location 540 WEST AVE Project Type Civil Use Project Use Right of Way Parent Project# Subdivision Applicant Name Ismael Rodriquez Address 12419 Beverly Park Rd, Lynnwood, WA 98087 Applicant Email it@ismaelsinc.com Phone 425-740-4809 Cell Owner Name STILLAGUAMISH SQUARE LLP Address 540 WEST AVE ARLINGTON, WA, 98223 Owner Email dale.dusking@me.com Phone 425-239-5074 Cell Contractor Ismael's Construction LLC Address 12419 Beverly Park, Lynnw000d, WA 98087 Contractor Email ismaels@ismaelsinc.com Phone 425 770 1722 Cell Type/Improveme Accessory/Struct nt ure Current Use Proposed Use Current Zoning OTBD-2 Proposed Zoning Project Cost 2500.00 Project Value 2500.00 Current Use And Sidewalk panel replacement Proposed Changes Lot Width Lot Depth Map Number Total Area of Building &Accessory Total Area of All Man-made Improvements Structures (Sq Ft) (Sq Ft) General Notes Restrictions/ Variances ©Community Development Online Portal Page 1 of 5 April 8, 2026 03:41 PM WASHINGTON Structure Information Structure Type # of Stories Usable Floor Area (Sq Ft) Structure Height null # of Units 0 Load per Floor (Lbs) Sign Dimensions # of Bedrooms null # of Bathrooms null Occupancy With Chairs Tables & Chairs Empty Room Foundation Foundation Type Footing Depth null Material Foundation Information Setbacks Front& 0 0 Setbacks Right & 0 0 Rear Left Sides Setbacks Information Water Utility Public Sewage Utility Public Gas Utility Public Electric Utility Public Driveway Width null # of Off Street null # of Off Street null Parking Loading Miscellaneous Information ©Community Development Online Portal Page 2 of 5 April 8, 2026 03:41 PM 4rtk( tot( WASHINGTON Contractors License # Business Name Type Contact ISMAECL901CQ Ismael's Construction LLC Out of City Ismael Rodriquez 602 991 617 Ismael's Construction LLC General Contractor Ismael Rodriquez ©Community Development Online Portal Page 3 of 5 April 8, 2026 03:41 PM 4rtk( tot( WASHINGTON Contacts Contact Name Type Project Address Phone STILLAGUAMISH SQUARE Applicant 540 WEST AVE LLP ARLINGTON, WA, 98223 Esmael Rodriquez Applicant 12419 Beverly Park Rd, 425-740-4809 Lynnwood, WA 98223 STILLAGUAMISH SQUARE Owner 540 WEST AVE 425-239-5074 LLP ARLINGTON, WA, 98223 Esmael Rodriquez Others 12419 Beverly Park Rd, 425-740-4809 Lynnwood, WA 98223 Ismael Rodriquez Applicant 12419 Beverly Park Rd, 425-740-4809 Lynnwood, WA 98223 Ismael's Construction LLC Contractor 12419 Beverly Park, 425-740-4809 Lynnwood, WA 98087 Ismael Rodriquez Applicant 12419 Beverly Park Rd, 425-740-4809 Lynnwood, WA 98087 ©Community Development Online Portal Page 4 of 5 April 8, 2026 03:41 PM 4rtk( tot( WASHINGTON Fees Fee Type Date Debit Credit Balance Project Fees December 18, 2025 $175.00 $175.00 $175.00 $0.00 T O T A L $175.00 $175.00 $0.00 ©Community Development Online Portal Page 5 of 5 April 8,2026 03:41PM