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2007, 01-22 Manufactured Home App ® 11917 E. Broadway Ave., Suite 102 St �,��� Spokane Valley, WA 99206 Phone (509) 927-7171 — Fax (509) 927-3393 title of spokane January 22, 2007 City of Spokane Valley 11707 E Sprague Avenue, Suite 106 Spokane Valley, WA 99206 ATTN: PLANNING RE: Escrow Number: 27473 Loan Number: 7603625-149 Borrower: Frances A. Mann Property Address: 14923 East Rockwell Avenue Spokane, WA 99016 Please sign the attached "Manufactured Home Application" so we can complete the Manufactured Home Elimination. Please return the signed document to the above address. We appreciate having had this opportunity to be of service to you. If you have any questions, or if we can be of help to you again in the future, please do not hesitate to contact us. Sincerely, Stewart Title of Spokane Laura J. Biddle For Greta Ebrecht Limited Practice Officer SCITY OF pokane MANUFACTURED HOME INSPECTION RECORD CARD PERMIT #: Lk, ` K \7alley OWNER: r l( C M 1 Y 11) t ADDRESS: )L (i� ')j Z_ f�C (�i�t �� 1 , ) \,(< u( I MANUFACTURER i) _ MANUF DATE: , D 0 Co MODEL:Kem L 'pa 2v0AERIAL NUMBER:H R O any/i 0 A 8 "HUD" LABEL/STATE LABEL NUMBER:O&E ij R 0 O y DATA PLATE: 02 4 q L) 40 S DEALER: .6 PP IMV l CE tJ'r4, DEALER#: o D O .a •k19. 614 ELECTRICAL-L& I FINAL APPROVAL: /.1 P P " 0 V , C] INSTALLER: Si (`, � ,j�l{�(� E'Li.C, WAVNE3#: / L V g *q g$ Q INSTALLER: WAYNES#: L1 c s # INSTALLER: SPO l( 14t-1 Cr•fr CQgt O f c3A..0 WAYNES#: i 9 3 INSTALLER: +[,t--10.1, ►Aa: ,? WAYNES#: INSTALLATION INSTALLATION #: ANCHOR#: INSTRUCTIONS US MANUFACTURER:I €1?M 1 Sb U /J STATE: 0 t' �•'�g 3 S� NFPA 225 FOUNDATION: FOUNDATION TO LOCAL BLDG CODE:GA r.1 s 130ck/-f'v £ G9iZySi3S0s5'K '4 SUPPORT: SUPPORT LOCATIONS PER MANUFACTURER OR ENGINEERED DESIGN: ELEVATION: ELEVATION OF LOWEST FLOOR(IF IN A FLOOD HAZARD AREA): p///) SUPPORT FOOTINI TYPE: g " u. •J pIt r2S -- 3 e - . ei-u. c, p 4o_, 6,0 / b " x' J � SIZE: 14 ( x ' X4741 ( MI t o [ )rJt, x U s- PIERS: MATERIAL Co c v € 1 C.- 3 L u C 1< SPACING: SHIMS: VJ O o LOT/SOIL CONDITIONS: R U c. K y -FL> & &A ✓ C (-- L ANCHORS: SPACING: 1 a % f 1 R C U E EQUIPMENT USED: EQUIPMENT APPROVED: FRAME REMOVED: PERMITED BY MANUFACTURER: "Jo (PRIOR TO 11/89) FOUNDATION TO LOCAL BLDG CODE: SUPPORT LOCATIONS PER MANUFACATURER OR ENGINEERED DESIGN: ELEVATION OF LOWEST FLOOR(IF IN A FLOOD HAZARD AREA): SKIRTING: TYPE: 5 S u `i" R Woo t) ATTACHMENT TOOME: Rp M f i) / G L- V A7/4 POLY ON GRADE: r 5 t t c V/9- P 6i a IR- ACCESS 2ACCESS PANEL: / A I- nl £R h o M t. COMMENTS *FINAL APPROVAL MEETS THE REQUIREMENTS FOR TITLE ELIMINATION EXCEPT FOR PARK PLACEMENT* INSPECTOR: KA (/ DATE/TIME: 10— O fO 4 ' '•v1 ORIGINAL COPY:CITY OF SPOKANE VALLEY ADDRESS FILE COPY FOR OWNER RETURN ADDRESS [re?11es Aft lot Ze0(5-0ui'h /etildod 59 G(i2ei1 f mil, 14A- 9909 Z74L75 Cie Manufactured Home PLEASE CHECK ONE dWASHINGTON STATE DEPARTMENT OF [TITLE ELIMINATION m LICENSING Application ❑TRANSFER IN LOCATION Anyone who knowingly makes a false statement of a material fact is guilty ❑REMOVAL FROM REAL PROPERTY of a felony, and upon conviction may be punished by a fine,imprisonment,or both.(RCW 46.12.210) D MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) 2006 Marlette 60 X 26.8 HERO25414ORAB © LAND LEGAL DESCRIPTION ON PAGE REAL PROPERTY TAX PARCEL NUMBER MANUFACTURED HOME WILL BE 0 AFFIXED ❑ REMOVED 45021.3704 LOT BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE QUARTER/QUARTER SECTION 4 2 Schmidt Subdivision © GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS NAME OF REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER Frances A.Mann NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 14923 East Rockwell Avenue Spokane Valley WA 99016 NAME OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER Horizon Credit Union NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER ADDRESS CITY STATE ZIP CODE 14523 East Trent Avenue Spokane Valley WA 99216 GRANTEE NAME I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE AM/ARE THE REGISTERED OWNER(S)OF THIS VEHICLE AND THIS INFORMATION IS ACCURATE: Signature of Registered Owner and Title,IF APPLICABLG�L�Y� -1-4--- r iawV"L.J Signature of Additional Registered Owner and Title,IF APPLICABLE NOTA•,.„;.'.B...`�".44,;4A P I NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE 03RECy‘‘) I State of Washington Signed or attested • 1 �P SON EXP/ T If County of SA `0. t� b�fore on I , 1 eft e Ki U' o� �0�.��s Z/� by }6 A( rk �'1 tl Signature I. i4"11` 1\ U / �v.. O PRINT NAME 0 REGISTERED OWNER !�'� ' la'\\ e1i �Ue oo % b C Z :€c ill (I, — ✓(JLY 25-" %I y PRINT NAME OF REGISTERED OWNER PRINTED NAME OF NOTARY i County/Office No.OR k‘ 40./.. I Title I JUI1).�' VY AND: Dealer No.OR��J'�SiZ'J: 1\\Vv •% 11� I DEALERSHIP POSITION/AGa:14T/NOTARY Notary Expiration Date 4 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 SIGNATURE/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. © BUILDING PERMIT OFFICE CERTIFICATION I Certify that CM the manufactured home has been affixed to the real property as described. 13 a building permit has been issued for this purpose and the attachment will be inspected upon completion. NAME(TYPED OR PRINTED) BLDG PERMIT OFFICE/PHONE# BLDG PERMIT# r 7 ___._�Cr. \ 'k\ \� _-- 2.- Th' C� ' ' 1z< 06-2907 SIG URE/ SITIOIs1 �--- DATE r .. ..:----/ G: c big.:, , 0 4, ' k-- 2._(\0-1 TD=426•' (R/6/06)W Page of 2 MANUFACTURED HOME-FROM SECTION 1 TPO/PLATE NUMBER YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) 2006 Marlette 60 X 26.8 HER025414ORAB 6 SIGNATURE OF LEGAL OWNER SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIMINATION OF TITLE/REMOVAL FROM REAL PROPERTY. Signature of Legal Owner and Title,IF APPLICABLE Signature of Additional Legal Owner and Title,IF APPLICABLE NOTARY SEAL OR STAMP NOTARIZATION/CERTIFICATION FOR LEGAL OWNER(S)SIGNATURE State of Washington Signed or attested County of before me on by Signature PRINT NAME OF LEGAL OWNER NOTARY OR AGENT by PRINT NAME OF LEGAL OWNER PRINTED NAME OF NOTARY County/Office No.OR Title AND: Dealer No.OR DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date D LAND DESCRIPTION (A legal description of the land can be obtained from the local County Assessor's Office) Lot 4,Block 2,Schmidt Subdivision,being a portion of Tract 25 Trentwood Orchards,according to the plat thereof recorded in Volume 4 of Plats,Page0s0 15. Situate in the City of Spokane Valley,County of Spokane,State of Washington. Tax Parcel(s)L 45021.3704 El DEALER'S REPORT OF SALE I CERTIFY THAT THIS INFORMATION IS CORRECT.THE VEHICLE IS CLEAR OF 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 SIGNATURE ❑USE TAX EXEMPT Sale to a Certified Tribal member on the reservation(attach notarized statement of delivery). a 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 OFFICENFS OPERATOR NUMBER SIGNATURE DATE 10 TITLE FEES FILING FEE APPLICATION MOBILE HOME FEE ELIMINATION FEE USE TAX SUBAGENT FEES TOTAL FEES&TAX 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. 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 cal(360)902-3600 or TTY(360)664-8885. TD-420-729 (R/6/06)W Page 2 of 2