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2008, 07-29 WA State MH Application RETURN ADDRESS C r,/;Lt1 ✓�C�/\.. �v S-I ice-- ni(S. ,AL - 2-.3 cI PLEA II ' • ` diWASHINGTON STATE DEPARTMENT OF Manufactured Home Q'TITLE ELIMINATION i LICENSING Application OTRANSFER IN LOCATION ❑REMOVAL FROM REAL PROPERTY 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 46.12.210) O MANUFACTURED HOME TPO/PLATE NUMBER YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) 137635 1984 FUQUA 152 X 28 SN8144 © LAND LEGAL DESCRIPTION ON PAGE REAL PROPERTY TAX PARCEL NUMBER I MANUFACTURED HOME WILL BE 'AFFIXED 0 REMOVED f 45202.1438 LOTBLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE QUARTER/QUARTER SECTION 5 I 1 RETTIG ADDITION © GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS DOL CUSTOMER ACCOUNT NUMBER NAME OF REGISTERED OWNER BRIAN F. LYNCH DOL CUSTOMER ACCOUNT NUMBER NAME OF ADDITIONAL REGISTERED OWNER ADDRESS CITY STATE ZIP CODE 704 S WOODRUFF RD SPOKANE WA 99206 DOL CUSTOMER ACCOUNT NUMBER NAME OF LEGAL OWNER SPOKANE TEACHERS CREDIT UNION DOL CUSTOMER ACCOUNT NUMBER NAME OF ADDITIONAL LEGAL OWNER ADDRESS CITY STATE ZIP CODE 106 W NORA AVE SPOKANE WA 99205 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: r� Signature of Registered Owner and Title, IF APPLICABLE 1rr..fl-A , -,,,err-- r",--1-( Signature of Additional Registered Owner and Title,IF APPLICABLE NOTARY SEAL OR STAMP I NOTARIZATION/CERTIFICATION FOR REGISTERED OWNER(S)SIGNATURE I State of Washington ! po w; f j Signed or attested ,/ ,I2,O-1 County of J before me on "' JESSICA R. BENSON 1 y `� NOTARY PUBLIC I ri• VV1"'�t'T Signature S t • 4' STATE OF WASHINGTON' �y RINT NAME OF REGISTERED OWNER ARY OR AGENT COMMISSION EXPIRESI0`"'It, 1-‘.0--' n NOVEMBER 9 y PRINT NAME OF REGISTERED OWNER INTED NAME OFCoNOTARY O AR ce No.OR1,I r+,D1 Title �O / AND: Dealer No.OR U, DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date O 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 DATE SIGNATURE/POSITION 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: I4 the manufactured home has been affixed to the real property as described. El 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# TURE(P SITION ` <:\ EDATE -4 Oj L 1. ) ti-AK 1� '-(.CLI'I:14-- l2�l\a) TD-420- 9 (R/6/06)W }ge 1 of 2 MANUFACTURED HOME-FROM SECTION 1 TPO/PLATE NUMBER YEAR MAKE LENGTH/WIDTH(FEET) VEHICLE IDENTIFICATION NUMBER(VIN) 137635 1984 FUQUA 52 X 28 SN8144 6 SIGNATURE OF LEGAL OWNER SIGNATURE OF LEGAL OWNER INDICATES CONSENT FOR ELIIAATION OF TIT REMO ,L 'ROM REAL PROPERTY. I Al Signature of Legal Owner and Title,IF APPLICABLE , i / Signature of A••' - .4.".,-,al Owner and Title,IF APPLICABLE A`'�` K��11 , NOTARIZATION/CERTIFICATION FOR LEGAL OWNER(S)SIGNATURE i le \gSION lt; to of Washington Signed or attested a i iici i Q x` ---1'Q l County of , (i` � -� before me on "f ell ����� j/Q UOQ NnC 01 s 4, .4Ry 9N '+/// Signature M. K—enr ii p(J H L I y NAME OF LEGAL OWNER NOTARY OR AGENT 1 YPi7ky Is% , ,; ti_SO_,A,M0Y-Z/Jy Donivu m. Kr/Intl/1 �� ,vo: =_ PRINT NAME OF LEGAL OWNER PRINTED NAME OF NOTARY ����cc _ /���.�L �/ County/Office No.OR //3;�/rr I t\\ WAS _' Title/ 65- • / a.// /'� `�VQ ' AND: Dealer No.OR \��\v��-� I DEALERSHIP POSITION/ GEN /NOTARY Notary Expiration Date DLAND DESCRIPTION (A legal description of the land can be obtained from the local County Assessor's Office) Lot 5,Block 1,RETTIG ADDITION,as per plat recorded in Volume 5 of Plats,page 14,records of Spokane County; INCLUDING the Mobile Home located thereon; Situate in the County of Spokane, State of Washington. 8 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 DEALER'S AUTHORIZED SIGNATURE ID 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 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 SPOKANE COUNTY TITLE COMPANY E(509)326-2626 NORTHBANK BUILDING,SUITE 203 TELEPHOFNE(509)326-2520 1010 N. NORMANDIE STREET ESCROW FAX(509)324-7570 SPOKANE,WASHINGTON 99201 July 28,2008 City of Spokane Valley Building Permit Center 11707 E. Sprague Spokane Valley,WA Attn: Manufactured Home Building Permitting Re: Brian F.Lynch 704 S.Woodruff Rd. Spokane,Valley,WA 99206 Our file No.: 23897 To Whom This May Concern: Enclosed a Manufactured l Section the form to me in the enclosed ncos d envelope. Please call for our courier service(326-2626)or give the form to our office next door to you and they'll see that it is delivered to me. Thanks very much for your assistance in this matter. If you have any difficulty complying with this request,please telephone. Sincerely,jJa Treecraft C sing Assistant