2006, 01-11 Title EliminationAFTER RECORDING MAIL TO:
First American Title Company
40 East Spokane Falls Blvd
Spokane, WA 99202 (File #656112-JLD)
Filed for Record at Request of:
First American Title Insurance Company
First American Title
Insurance Company
,,r.( r,�,��,;�r„�,+,,,�, MANUFACTURED HOME
jJ�d1� teuart �+� ' APPLICATION TITLE
ril
ii:ICEf SIDG TRANSFER
Anyone who knowingly makes a false statement of a material fact is guilty ❑
of a felony, and upon conviction may be punished by a fine, imprisonment, or both. (RCW
PLEASE CHECK ONE
ELIMINATION
IN LOCATION
REMOVAL FROM REAL PROPERTY
46.12.210)
1 MANUFACTURED HOME
TPO/PLATE NUMBER
`tIk tZ
YEAR
1999
MAKE
MDULN
LENGTH/WIDTH (FEET)
28 y 40
VEHICLE IDENTIFICATION NUMBER (VIN)
118781
Ell LAND LEGAL DESCRIPTION ON PAGE 2
MANUFACTURED HOME WILL BE
REMOVED
REAL PROPERTY TAX PARCEL NUMBER
45173.1124
X AFFIXED
LOT
BLOCK
PLAT NAME OR SECTION/TOWNSHIP/RANGE
//
OUARTER/OUARTER SECTION
Ell GRANTOR(S) REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY NUMBER
0148
NUMBER OF REGISTERED OWNERS
1
NUMBER OF LEGAL OWNERS
NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
Margaret C. Asbell
NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
231 North Farr Raod, Spokane Valley, WA 99206
NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
same as registered
NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
ADDRESS CITY STATE ZIP CODE
GRANTEE
NAME
Margaret C. Asbell
I DO SOLEMNLY ATTEST UNDER PENALTY OF
THIS VEHICLE AND THIS INFORMATION IS ACCURATE:
Signature of Registered Owner and Title,
ktlNt6fliitional Registered Owner and Title,
PERJURY THAT I/WE AM/ARE THE REGISTERED
/
IF APPLICABLE J� 27 _.. _., '. at -Le
OWNER(S)
OF
-`—
IF APPLICABLE
414
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StateNOT
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i by
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-rifle
of
County
Margaret
ARIIZATION/CERTIFICATION FOR REGton ISTERED
of Spokane
before
Mary
or attested
OWNER(S) SIGNATURE
me on 12(9//005
C. Asbell Signature
L i '``-�_��.--�__
_yam_
PRINT NAME OF REGISTERED OWNER
NOTARY O�AGEMT _ _
Beth VanDyke
PRINT NAME OF REGISTERED OWNER
Notary AND
PRINTED NAME OF
County/Office No.
Dealer No.
Notary Expiration
NOTARY
OR
OR 10/17/2009
DEALERSHIP POSITION/AGENT/NOTARY
Date
fl TITLE COMPANY CERTIFICATION
I certify that the legal description of the land and ownership is true and correct per the real property records.
NAME (TYPED OR PRINTED) TITLE COMPANY/PHONE NUMBER
Tiffany Ipock, First American Title Insurance Company (509)838-5281
SIGNATURE/POSITION DATE
Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs.
5 BUILDING PERMIT OFFICE CERTIFICATION
I certify that: ❑ the manufactured home has been affixed to the real property as described.
❑ a building permit has been Issued fororthis purpose and the attachment will be Inspected upon//completion.
NA PED R` RINj�j3� \`�\ BLDGPEW'
U2-OFFXE/yH
`\ \^�
BLDG
�JJ PERMIT•.�
SIGNATU
j
/POS
� a DATE
1 h 4+- i)1,(- Sig C.�Ce0( 14 -\\-CC)
s`
3
D•430 -X19 f4ANUFHOME APPC(R/2/02)OR (W)Page of
First American Title File No. 4251-656112 (JLD)
MANUFACTURED HOME — FROM SECTION 1
TPO/PLATE NUMBER
YEAR
1999
MAKE
MDULN
LENGTH/WIDTH (FEET)
28 X 40
VEHICLE IDENTIFICATION NUMBER (VIN)
118781
6 SIGNATURE OF LEGAL OWNER
SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION
Signature of Legal Owner and Title, IF APPLICABLE
Signature of Additional Legal Owner and Title, IF APPLICABLE
OF TITLE/REMOVAL FROM REAL PROPERTY.
NOTARY SEAL OR STAMP
I
State of Washington
by same
NOTARIZATION/CERTIFICATION FOR LEGAL OWNER(S) SIGNATURE
Signed or attested
County of Spokane before me on
Signatur
as registered e
PRINT NAME OF LEGAL OWNER NOTARY OR AGENT
I by
I PRINT NAME OF LEGAL OWNER PRINTED
Title Notary AND
NAME OF NOTARY
County/Office No. OR
Dealer No. OR
Notary Expiration Date
• DEALERSHIP POSITION/AGENT/NOTARY
7 LAND DESCRIPTION (A legal description of the land can be obtained from the local County Assessor's Office)
TRACT B OF ALTERED SHORT PLAT 01-1274, RECORDED IN BOOK 18 OF SHORT PLATS, PAGE 6A AND 7A, IN THE CITY OF
SPOKANE VALLEY, SPOKANE COUNTY, WASHINGTON.
8 DEALER'S REPORT OF SALE
I CERTIFY THAT THIS INFORMATION IS CORRECT. THE VEHICLE IS CLEAR 0 ENCUMBRANCES EXCEPT AS SHOWN. ANY
REQUIRED SALES TAX HAS BEEN COLLECTED.
DEALER NAME (TYPED OR PRINTED)
WA DEALER NUMBER
DATE OF SALE
PURCHASE PRICE
TAX JURISDICTION/TAX RATE
DEALERS AUTHORIZED SIGNATUREi
USE TAX EXEMPT Sale to a Certified Tribal member on the reservation (attach notarized statement of delivery)
9 COUNTY AUDITOR/AGENT LICENSING OFFICE APPROVAL: (Not for use by Subagents)
I certify that the above application appears to have been completed correctly, and the applicant has sufficient documentation to
proceed with the recording of this form.
NAME (TYPED OR PRINTED)
COUNTY OFFICE/VFS OPERATOR NUMBER
SIGNATURE
DATE
10 TITLE FEES
FILING FEE
APPLICATION
MOBILE HOME FEE
ELIMINATION FEE
USE TAX
SUBAGENT FEES
IMPORTANT:
Once the application has been approved by the County Auditor/Vehicle Licensing
Office, take your application form to the county Recording Office. Retain proof of the
recording fees paid. If the Recording Office retains your original application form,
obtain a certified copy of the recorded form.
TOTAL FEES & TAX
APPLICANTS: Once recorded, you must return to a Vehicle Licensing Office to file the
Manufactured Home Application, paying all required fees. Vehicle licensing
subagents charge a service fee.
For full instructions on completing this form for title Elimination, Removal from Real Property or
Transfer in Location, see form TD -420-730, Manufactured Home Application Instructions.
The Department of Licensing has a policy of providing equal access to its services If
you need special accommodation, please call (360) 902-3600 or TDD (360) 664-8885
TD -420-729 MANUF HOME APPL (R/2/02)OR (W) Page of
DEC -08-2005 09:56 MAIL BOX CENTER
5099243668 P.02
BUILDING DIVISION
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Site Information
Project Information
Site Address: 231 N FARR RD
Parcel Number: 45173.1124
Subdivision:
Block: Lot: B
Zoning: UR -3 Urban Residential 3.5
Owner: JOHNSTON, DON
Address: 231 N FARR
SPOKANE VALLEY, WA 99206
Building Inspector: BOBBY STONE
Water Dist: MODERN
Project Number: 05003852 Inv: 1 Issue Date: 10/17/2005
Permit Use: MANUFACTURED HOME SET
Applicant: CURTIS PRICE
16424 N YALE
COLBERT, WA 99005
Contact: CUR 'i IS PRICE
16424 N YALE
COLBERT, WA 99005
Phone: (509) 217-1828
Phone: (509) 217-1828
Setbacks - Front: 15 Left: 25 Right: 75 Rear: 35
Group Name:
Project Name:
Permits
Manufactured Home Contractor UNKNOWN
INSPECTION FEE
FOR MANUFACTURE HOME INSPECTIONS CALL (509) 688-0054.
License #: UNKNOWN
2 S100.00
Total Permit Fee: $100.00
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 5100.00 $0.00
Processed By: JANSSEN, C1.1RISI' 11NA
Printed By: KURTZ, KARI
Tran Date
10/17/2005
Page 1 of 1
Receipt #
3164
Payment Amt
$100.00
PERMIT
DEC -08-2005 09:56 MAIL BOX CENTER
.141-4....0,4116.... i..r.r.... weft •akr
INSPECTION RECORD CARD
MUST REMAIN POSTED IN A CONSPICUOUS PLACE ON JOB SITE
NUMBER:
-.30B ADDRESS: 31 PROJECT NUMBER:
5099243668 P.03
OWNER: MANUFACTURER:
CERTIFIED MANUFACTURED HOME
INSTALLER NAME: INSTALLER CERTIFICATION NUMBER
THIS SECTION FOR cm USE ONLY
Th. IIAIS DATE
WASHINGTON STATE
HUD #:
THIS SECTION FOR USE BYPERSONSRESPONSIBLE FOR SETUP/
INSTALLATION OF THE MANUFACTURED HOME
E.: CERTIFIED INSTALLER OR HOME OWNER
PERFORMING THE WORK)
DESCRIPTION OF WORK SI
1: Construction of foundation
; ' . system footings;
2: Installation of support piers:
' y,3 Zastallation/adjustment of
anchorage devices:
linection to on site water,
ssewer, electrical servicer:
Skil ttmg/ventlation and
t.f!''ttrouud cover.
ATURE
DATE CERT. N
6:: Extension of water heater TPR
..,,valve, clothes dryer duct etc.:
7. Address posted and visible
from the road?
THE AUTHORIZED SIGNATURE BELOW WARRANTS THIS
MANUFACTUREDHOME HAS BEEN INSTALLED IN ACCORDANCE
WITH W.A.C. 2 150M FOR MANUFACTURED HOMES AND/OR
THE ACI'URERS INSTALLATION INSTRUCTIONS.
CERTIFIED INSTALLERS SIGNATURE
OWNERS SIGNATURE OF APPLICABLE)
Site Review/
Site Preparation:
Other:
AREA
SPOKANE VALLEY
NOTICE OF INSPECTION
40, GT-rr—
PROPERTY ADDRESS:
23? isir cgp
PROJECT NO Off-
OWNER Kul 21.1 ( 462/
CONTRACTOR
INSPECTION TYPE:
i•-� Rh4L `»_ N _
STATUS
APP
WORK LISTED ABOVE:
CORRECTIONS
NEEDED
NOTES:
BY:
INSPECTOR
/1/21p -
QUESTIONS? CALL OUR OFFICE;
HU``ILDING DIVISION
OFFICE INSPECTION LINEG(509) 686-0054
CALLED IN:
DATE
D
Ili 1 I 1 1. 1) 1 N (: 1) 1`= 1' : IZ, .1' ,l 1E N1'
1 1 7 II 7 11 1 r l i• 1 . 1
o is
\ 1
\' \ 1. 1 1
11 V 1 11 II ,i (Y 1 1 1
\'. 1 1 1 i' 1 I)lY
\ `3 `7 i (1 6
I 0'11 bSS 1111 t-.
TOTAL P.03