Application_990308CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #990308
Applicant
First Name Last Name Company Name
Rod Gotthold
Number Street Apartment or Suite Number E-mail Address
20905 Woodlake Dr rgotthold@comcast.net
City State Zip Phone Number Extension
Edmonds WA 98026 3606074699
Contractor
Company Name
MATUSKA HEATING SERVICES INC
Number Street Apartment or Suite Number
759 Laurel Street PO Box 1115
City State Zip Phone Number Extension
Edmonds wa 98020 425-776-4867 206-949-1830
State License Number License Expiration Date UBI # E-mail Address
MATUSHS012KK 8/2/2021 FD 1 q 1 9974 rgotthold@comcast.net
Project Location
Number Street Floor Number Suite or Room Number
20905 WOODLAKE DR
City Zip Code County Parcel Number
EDMONDS 98026 00637700001300
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Rodney E & Takade Melissa S Gotthold
Number Street Apartment or Suite Number
20905 WOODLAKE DR
City State Zip
EDMONDS WA 98026
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and
correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By
submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above
may result in revocation of the permit.
Date Submitted: 7/13/2021 Submitted By: Rod Gotthold
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #990308
Project Type
Single Family Residential
Project Details
Fixtures
Water Heater - Gas Mechanical
Work Location
Activity Type
Repair or Replacement
Work Description/Location (example: 1 st floor, lower floor
Master Bath, Garage)
Scope of Work
Plumbing
Page 2 of 2