HomeMy WebLinkAboutBLD0415 MFG Home - BLD Permit / Conditions - 6/10/1991 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. C
OWNER NAME _ MAIL ADDRESS' ( :tL(;Lr=f% ' CITY&STATE ZIP PHONE
DIRECTIONS Tu,e I O rJ TO JOB SITE 3 /�y�Z ��EIC�. WE^S'�" tll� G(�"{�-1 OM 1+W 3 b 4
t-AnoN e. ko up ya mtc.-e - Peafap-T fs a N aF P®"
PARCEL LEGAL I £ m bow
NUMBER a 3.1 23 "j�f�a-4 DESCR. G Z aF NW/ 40v 1 !fir Z Sec- 31 TlU1�j�3 n
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP HON
CONTRACTOR
USE OF
BUILDING ofyvE
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE � ,,� �`
WORK MOUE M(.f1�-r—1tkg70 Htwz a amn VE O JErcCR
W, 1 tt (kT a
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS 2- TOTAL SQ.FT. hod GARAGE N� CONDITIONING.
NO.OF STORI ES _L BASEMENT r q ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. �L7—GO FIREPLACE STo'(E DETACHED —_ ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE N
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APP AL F310M T"BUILDI!$dDEPA MENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER L ATE Q XBY DATE
FOR OFFICE USE ONLY /
DEPARTMENT YESPPROVENo DEPARTMENT YES
APPROVED
NO BUILDING VALUATION d
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP f �� PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPR ED R IgSUAN E PERMIT VALIDATION
TOTAL / l .45�
BY ASH CK MO
S_ Gordon Craiq
1 r
the
.Mason city
assessor
IIea c
Ge b3ve recancly rxaived a copy of tax esrtiticate for mobile home
movement on your mobil* home.
In order that we may accurately, value you mobile hc=c, please complete
ehe questions below and return this form to our office by
It. is imperative that this information bo provided to prevent a
passible double assessment_
MOBILE HCME DATA LIIYGH
I�DQ.
� rn�r ►r� � P�Noc�Tee✓ q
isoalLE fiD
HCHE L.CCA7113M INFDRMATIQM SEILTAL CO ZZA,6
A_ My privately owned Land_ �S x _ /FSE LEFT/�tPJ
S_ If reared or Leased Land who from? ZIAg
ADVSL=5 C�cs�. 13 3
cz z s s aEc.f (j
C_ Rea L ?"Party Parcel (tax statement *) I Z 3 3 I - 2 z
D- Mailing name and address foc ovwer of vabils bomt
Lvi LL- et. .. ta2�Cn►a�Ya 6 014quA RirzS Air,
M ��c_� Le _ Tide. .4. �` PICI;Pv4b 6 --ro�a .
� ii,3
AD02=5 1,61 I-APUct.i 4& /tG CITC & STATE OjE-L-r-4fe
E_ Lacacion address of rsobile home J�'!�'lt CITY
F_ Data mabtic home was placed on present site P RCr' I(YL
C_ Purchase P:ice�3 $� �/ SCJ
DATE:
TYPE DR PRL4T NAME /tL--5l. 0' YAe f��7
Trt =��IaNE N1ll0Ex (Lcc)G b'- 107 76
Courtncuse Sheftan, Wastningtan 9SUA Phone 427-9670
- - -
6-r--!r4iled for Record at Request ofw ~
,ref HOME TITLE CO. OF MASON COUNTY
AFTER RECORDING MAIL TO:
JOHN H. BYERLY
;,• �.�
PO BOX 133
BELFAIR,WA 98528
HOME TITLE CO. #19638
Cscaamesaes.-asp=sa=s�s�a�mmsaa==a.-�--_=�=sari=tsasmcssiraspo�sse
STATUTORY WARRANTY DEED
„ • THE GRANTOR ELDON DILLENBURG AND JOAN DILLENBURG AKA JOANNE DIL
BURG, HUSBAND AND WIFE
for and in consideration of TEN DOLLARS AND OTciER VALUADLE
CONSIDERATION in hand paid, conveys and warrants to THE GRANTEE
JOHN H. BYERLY AND SHIRLEY BYERLY , HUSBAND AND WIFE
the following described real estate, situated in the County of
MASON, State of Washington:
TRACT(S) D OF SHORT PLAT 90. 1198� AS RECORDED OCTOBER 28,
1982, UNDER AUDITOR'S FILE NO. 408592, AND BEING A PORTION OF
THE EAST HALF OF THE NORTHWEST QUARTER OF GOVERNMENT LOT 2, IN
SZCTION 31, TOWNSHIP 13 NORTH, RANGE 1 WEST, W.M.
Subject to easements, restrictions, reservations and covenants
of record contained in HOME TITLE COMPANY of MASON COUNTY,
INC'S preliminary commitment No. 19638; PARAGRAPHS NO. AS
ATTACHED PER EXHIBIT "B"
Dated this 6th da SE TEMBIO, 1990
kff N DI LE BUR -
4N!T1-cLLEN URG
STATE OF WASHINGTON,
County of Mason
On this day personally appeared before me ELDON DILLENBURG
AND JOAN DILLENBURG to me known to be the individual (s)
described in and who executed the within and foregoing
instrument, and acknowledged that THEY signed the same as -THEIR
free and voluntary act and deed for the uses and purposes
therein mentioned.
GIVEN under my hand and official seal this 1� Riop
..
r..
Ndtary Public in and for the Sp,ate ,
of Washington, residing at (o iT OAC,
My commission expiresis �_
2_3 900 7_4 «....�..
�a
. , SEP 18
O ! et O DORENE RAE
a a Tm...Maw"
Coast)'
9<.
�HEITON( 401on0laamv"TON
RAX OM�DA,o�ia•
LEASE AGREEMENT
THIS LEASE dated this k day of =LLY1E , 199 ,
is made by and between T,eMLAK Liinnfo&D ¢ VI)FSLrX
hereinafter referred to as Tenant , and Ay-)
-Y hereinafter referred to as
Landlord;
W I T N E S S E T H:
FOR AND IN CONSIDERATION of the mutual promises ,
covenants and conditions hereinafter set forth, the parties
agree as follows:
A. PREMISES: The Landlord hereby leases to the Tenant
and the Tenant accepts the same, in the condition currently
existing in the following described property located in the
NE ��
County of Mason , State of Washington: ,ir
City of Belfair , County of Mason, State of Washington.
B .TERM: The term of this lease shall be for a period of
ONE }rEnk commencing on the 1!�- day of
19 y/ This lease may be renewed as provided in the
following paragraph.
C. RENEWAL: This lease shall be automatically renewed
for continuing�RfE P6-rk terms unless, at least thirty (30 )
days prior to the termination date of this le-)se, either
party thereto gives to the other party notice of its
intention to either terminate or to renegotiate this lease.
The notice of intention to renegotiate shall be deemed to
have the same effect as a notice to terminate. Any notice to
LEASE AGREEMENT - 1
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9S 77//77 -.AM; ' �SG-17 bb /a,c7� 'J, �l�13GG�CGIOJ
smo77o.� S� :7sF/r7Jd'`7�,� '7 uv su./a�3! y1in7.
i
J ,
X_ S FAF/RST 6ANX
I ( I I I
I Jill
rt t I t t t t " It I ; t
This is a ❑F.I.R.M. 60 ❑F.I,R.M. 30 ❑Fixed Rate Contract
In this agreement the words,1,me and my mean each buyer who signs below.The words you and your mean the seller Ranted below who is the creditor making the disclosures.This
agreement covers my instalment purchase front you of the mobile home and any other property described below.If I am one of two or more Buyers signing this Contract,I agree we
will all be responsible to perform its terms.I also agree you may enforce it against any one or more of its.You have my permission to transfer this agreement to Seattle-First National
Bank in which case the words you and your mean Seattle-First National Bank. I'll then make my payments directly to the bank.
SECURITY: I give you a security interest in the following property(collectively called the"mobile home"): (1) the mobile home I am purchasing described below(2)all parts
equipment and accessories to it(3)proceeds(4)any other property described below(5)any insurance you provide or finance and(6)any tax and insurance fund.This security
interest secures all of my obligations under this contract.I will deliver to you any manufacturers statement of origin for the mobile home which comes into my possession.If I also
will be giving you a deed of trust, a copy is attached. I will sign the deed of trust when you require it.
MODEL YR. MAKE OR TRADE NAME MODEL NUMBER SERIAL NUMBER NEW OR USED WIDTH LENGTH
11,r ,'.1.'tl.l':'I"I'!' 1'! .;! i rr , )n f:1: tJI bl 2tt r,r,
INCLUDING THE FOLLOWING SPECIAL ACCESSORIES AND EQUIPMENT:
,i r'11 J �t. t, ?: ''�.; I•,tl?'i rulli ;( -i(1 ,,., 1) 7r.
COMPLETE DESCRIPTION OF OTHER PROPERTY(IF ANY).
. .`Mailing Address t A
Mobile Home to be located at:
(i!,tttl gi';Ur�l' ili�� I�r , p,.l t ii, ., i ;r)ti F;I'I',;A11 VIA 9tl310
INSURANCE
PROPERTY INSURANCE IS INSURANCE)FROM
ROM I UNDERSTAND I CAN GET ANY f 9pGEBIDED nINSURANCEIC GET CREDIT LIFE AND CREDIT DISABILITY INSURANCE ARE NOT REQUIRED TO OBTAIN CREDIT.I
4HIS INSURANCE PLUS LIABILITY ITHROUGH EYOU DM MY OWN INSURANCE COMPANY OR A6ENi OR I CAN GET CAN GET THIS INSURANCE THROUGH YOU IF I WANT IT.
I vnnl: Coversye Amount Term Moe. Premium I went: Ceversfe Armorial Two Prwha
OWNER'S INSURANCE ❑ credit life insurance 1 0.00 O i 0.I I
Fire and Theft coverage and actual
' ❑ cash value of loss 1 1 ❑ credit life and disability ins. i i
❑ joint credit life insurance 1
❑ OTHER INSURANCE(describe fully) i 1 ❑ joint cr. life and single cr.disability ins. 1 0.l It I (} 1 I;,I
Please get u the insurance checked above at the costs and terms indicated.I undeisland that you will not gel me insurance unless the approplia le inlormauon is filled in above and I sign below I must get required propedy insurance mysell it you aid not getting it for De The coverage and
disklily benefits specified below ate based on the assurnphon that the APR will not change,II this is a variable rare loan,the APR may change.II it increases,these benefits may nor be sufficient to pay the balance due or the monthly payments,as appiiahle.
X X
Date signature of Principal Insured Dale Signature or Additional Insured
ITEMIZATION OF AMOUNT FINANCED (THE AMOUNT OF CREDIT PROVIDED TO ME OR ON MY BEHALF)
1.Price of mobile home purchased $ '+ r 't' t 9.Prepaid Finance Charge: (Computed at contract rate not buydown rate)
2.Sales tax on$ $ t t' f A. Contract fee
3.Cash rice of mobile home purchased 1 + 2 $ /m 7, ) - t t $
4.Downpayments: / I , Total (9A +9B) $
A. Cash $ 10.Amount Financed(8 —9) $ 42,N U 2,w)
B. Trade-in( ) $ "- t • ;, I „ 11.Finance Charge(use C if there is no buydown)
Total (4A + 48) $ (A, B, C are computed on the unpaid balance of 8)
5.Balance due on mobile home and any other property A. Periodic Finance Charge at rate o1 -
purchased (3 —4) $ , •' " ().(HA per year for first 0 months
6.To insurance company(s)for total insurance t; t of contract. $ (11,(
premiums financed(see insurance breakdown) $ B. Peri�diFf )Vnce Charge at rate (t
7.Other charges which are financed: of . 96yt,aer y ar.foi,µkA. Filingfee to State or Count $ 1 l.tr(I n>;Ut7+
Y remaining contract term. $
B. Excise tax fee to State or County $ C. Periodic Finance Charge at rate
C. Mobile Home title fee to oft `'• 50 %t per year $ 54.522.1)6
State or County $ ).t I'f D. Prepaid Finance Charge(9) $
D. Other: $ r t_ il) E. Other Fee $ NSh n .
Total7A + 7B + 7C +7p 1 ' S5e37'l.I)U
( ) $ Total (11A + 118+ 11C+110 + 11E) �„ $�_��
8.Total (5 +6+ 7) (Periodic Finance Charge is computed 12.Total Safe Price(4 +10+ 11) $
on balance of this amount.) $ 13.Total of Payments(10+ 11) $
t This periodic finance charge rate is subject to change after 30 months from start of contract(if this is a F.I.R.M.30 Contract)or after 60 months(it this is a F.I.R.M.60 Contract)in accordance with
changes in an index, Index is now t)•r Ir Ii I %
DISCLOSURES
ANNUAL FINANCE CHARGE Amount Financed Total of Payments Totel Silo Price
PERCENTAGE The dollar amount the The.arnount of credit The amount I will have The total cost of my pur-
RATE credit will cost n)e after provided to me or on niy paid after I have made chase on credit,including,
The Cost of my credit as I have made all payments behalf, all payments as scheduled. my down p$ym1.119
nt 4I
a yearly rate. as scheduled. 4, /S b.16
I S. I 24 $ $ cili, Itf l .ill) $
My felyrosal schedule will he month ,ueleu otherwlu specified
Num r, ayments Amount of PaymAnt .. When Paymtipl re quo;Starrino
s MONTH
a MONTH Y VEAA
"INK. YEAr�*t.. ..Ni wa),.,,.a�.,,�ynt.a.„:rb-0a.s<, r.. .^r.,�.(r,{wMMr4,... ,�.«aw....,....rr,...., nr ...__...
.*k.., ^ra�tne .vzvMY.'Vf!*-ek f+f.r.. t( e+ ara�1 �'rI
�...1. J4 Ia i(4Gf..�-r t 1.rrb•
*VARIABLE RATE.If this is a F.I.R.M.30 or F.I.R.M.60 contract,the figures marked with""'are subject to change because the annual percentage rate(APR)paid may increase(or decrease).
See the attached"F.I.R.M. 30 Manufactured Housing Disclosure"or"F.LR.M.60 Manufactured Housing Disclosure"for more detail.
❑ESTIMATED DELIVERY DATE: I I'; The Finance Charge(and each disclosure which includes it)is an estimate based on this date.
SECURITY;I am giving you a security interest in the property being purchased,and
(describe other property,if any).Collateral securing other credit transactions with you may also secure this contract.
LATE CHARGE.If a payment is more than 15 days late, I will pay the lesser of$5 or 5%of the unpaid amount of the payment.
PREPAYMENT. If I prepay this contract in whole or in part, I will not have to pay a penalty. I will not be entitled to a refund of any fee included in the finance charge.
ASSUMPTION.
Someone buying my mobile home will not be allowed to assume the remainder of the contract under the original terms and conditions.
Someone buying my mobile home,subject to certain conditions,may be allowed to assume the remainder of the contract under the original terms and conditions.
I understand I should see the contract,any attached"F.I.R.M.30 Manufactured Housing Disclosure"or"F.I.R M.60 Manufactured Housing Disclosure"and any attached dead of trust forany
additional inlormannn about non-payment,default,any required repayment in full before the schedule date,prepayment refunds and penalties,security interest and assumptions.
WARRANTY DISCLAIMER. I understand you don't provide any warranties whatsoever, and the mobile home is sold AS IS AND WITH ALL DEFECTS, unless a
warranty page is attached to this agreement.Any new mobile home warranty by the manufacturer(not you)will be in the information provided by manufacturer.
THE ABOVE DISCLOSURE, THE TERMS AND CONDITIONS ON THE REVERSE, ANY ATTACHED F.I.R.M. 30 OR FA.R.M. 60 DISCLOSURE
- r •,•,. ..�......•.... n�nn .... Tn„nT .,r .n.- nr tin .n •-�..�.,..
coRM 500 (� CNT
ROY HO S, INC.
A PLAIN LANGUAGEXig Avanue, KW �2f7fi$MMt IW 7WI WAmIn Vft
PURCHASE AGREEM ,VIA-8M Re,WA 98424 OlYrrtpla,WA WW6
UCC §2-201 } �/-3W `M)922-SM (2W
/�pp /►�/ DEWEar
BUYER(S
/{ /L „�i\
ADDRESS15-74/
��'�•�/� �.+ 4,".'' .��, �^�� •��S 7Va ���
in tNs contract the words,4 g! ,and Ty refs)td tfii Bu*krta _ )!#limp this contraC The Mods you and your nsMr to ttw D*&W.
SuWact to the terms and condNions on both slip of this syra@mVqt' .. to esll and I agraa to purchaes the following described unlL
M %8 MO y �. , .} Y BD.R MS E R SIZEHITCH SIZE STOCK NUMBER
�FnA_NUM6_i-r ". "I PROPOSED DELIVERY DATE KEY NUMBERS
EW USED
LOCATION R-VALUE THICKNESS TYPE OF INSULATION Ee PRICE OF UNIT $ ,38SS�i6o
CEILING / SS OPTIONAL EbUIPMENT i
EXTERIOR
FLOORS - .Z t IRT �16 DOo B-TOTAL j
THIS INSULATION INFORMATION WAS FURNISHED BY THE MANUFACTURER AND
! R 3 to
� !S DISCLOSED IN COMPLIANCE WITH THE FEDERAL TRADE COMMISSION PULE SALES TAX
16CRF.SECTION 460.16
OPTIONAL EQUIPMENT, LABOR AND ACCESSORIES NON-TAXABLE ITEMS j
Ftn_YAi_ILtJBi't E HOMES. INC. WILL. S VARIOUS FEES AND INSURANCE O 00
.e-where amessib!e by trttcic
f a ,- otie7 &ytdt''m d !s neadt d the cW. vAN be Cue- 1. CASH PRICE S
tie{s r ,rtti. TRADE
j
�K'�� S$t+'E- f. tft�t?� !� be br lRt$ET LESS s.4LDUE ON 43CV=
T TG,'rta.imster of 6 e1F'3X qW, 16 feet. NET ALLOWANCE i $ // pl (I
t I;I3rt6� �' fGt�f�. CASHDOWNFAVMEN'i
CASHAS E'E_AGR
rea` 7-Jb;y fo7 eIB�aJ or hooi(-tSD. c- rc
a toe`tw before home is Set-+ . 2. LESS 70TA_CREDITS c (�
i
ho:!te is rvsto::i ordered, a mii*rwm O` 101%'_ deposit SUB-TOTAL c
raqjlred bafone home wflt be ordered, rson-refurxtabi'e• SALES TAX(I?No!Included Above)
Till l deposit Of$5W.00 i6 rIBQi ed to Hold hflms In 3. Unpaid Balance of Cash Sale Price cok
for 10 dep. I Title to said equipment shall remain in you until the
pe-r+r&, it13p8• & fees tC, be pwchaSe e W agreed purchase price therefor is paid in full _ in cash
i or by the execution of a Retail Installment Contract,
rtmn#tg gear on aft hOmsu. ! or a Security Agreement and its acceptance by a financ-
i ing agency: thereupon a title to the within described
r 1L0 1 unit passes to the buyer as of the date of either full
l cash payment or on the signing of said credit instru-
_
8 L 6 E T14TES ments even though the actual physical delivery may not
be made until a later date. j
You and I certify that the additional terms and conditions
printed on the other side of this contract are agreed to
1:f BSAC r Ta Fib ,artA_)C-JN as part of this agreement. the same as if printed above
the signatures: I am of statutory age or have been legally
emancipated. I am purchasing the above described unit:
REMARKS: the optional equipment, accessories and insurance, if
included, voluntarily. My trade-in is free from all claims
in
except as noted. You and I agree that if any
paragraph or provision violates the law and is unenforce-
BALANCE CARRIED TO OPTIONAL EQUIPMENT ;'� i: _- able, the rest of the contract will be valid.
DESCRIPTION =-"1 YEAR
MAKEWODE_ BEDROOMS SIZE This agreement contains the entire understanding between you and me and
COLOR SERIAL NO TITLE NO j no other representation or inducement, verbal or written, has been made
AMOL1W OWING TO WHOM which Is not contained in this contract.
TRADE-IN DEBT TC BE PAID BY DEALER ❑ B i OR WE, AC ^AILEDGE RECEIPT OF A COPY OF THIS ORDER AND THAT
R WE AVER AD ANDJUNDEEP3TAND T B THIS AGREEMENT.
ROYAL MOBILE HOMES, M. D:ALFa ! SIGN " .-- -_—_--- BUYER
�+ c
ar we =anc Aecearec c.a-D"Le a me Company SOCIAL SECURITY Pdr)L �1�l —123z_ ---- -
SIGNED BUYER
ec .c ace a o'nnar,ng Dy Dan.o•lmance company SOCIAL SECURITY NO _k 72 �o
FORM 500.3 Masroutah IL62756m. Copyright 19W DUPLICATE
ENERGY _ - - - -
QUALIFIED - - -- ---
HOME
T,
FINANCING
ENERGY QUALIFIED HOME CERTIFICATE
This is to certify that the home manufactured by
(`L�IZl.I l"17 i 110 MES 1 INC. .
is an ENERGY QUALIFIED'"Home
C`U11L1.1:1"Cli I1U�11:S INC.
Manufacturer Name: ' Customer Name
2522 nt;l�a�i�
Serial Number: Street Address
Date of Manufacture: JA NUARY 1988 City State Zip
Manufacturer Signature ,1
Pub No.15-MH-13729 Prime,]m U.S A.J,—y. 1,mb Copyright Co 1966 Owens-Corning Fiberglas Corporation
cr .�- �i�' �t'�' i.. �+•�M���':a+w•}+y .y++aawQ�✓n+�.>e«iptipR+a+He" - aR�`i�!�J:t'i'iR'iye::,�'Y:�
CONSUMER INSULATION AND AIR QUALITY INFORMATION NOTICE
Marlette Wmes inc. a
home manufactured try '
t70F 2522 A$B
Serial fi contains the following insulation:
Manufacturers Signature
LOCATION TYPES OF INSULATION 'THICKNESS —R"VALUE
FLOOR
OwLis-C.:i-..N'I �G-FIiERGLks W1 _'t-11
EXTERIOR WALLS , ,.,, N c 6-V„ a
CEILING
OWEl,E-CI RL kl-,I 8 7/8 R-28
This insulation information was furnished by the home manufacturer and is disclosed in compliance with the Federal Trade
Commission Rule, Labeling and Advertising of Home Insulation, 16 CFR Section 460.16.
"R" values certified by manufacturers of insulation for thicknesses installed in this home.
Savings vary. Higher R-values mean greater insulating power. If you buy too much insulation,
it will cost you more than what you'll save on fuel.
I hereby acknowledge receipt of this information and understand that a copy of this form will be included with my sales
contract.
Dated - ' - f Customer's Signature` _,w
1 hereby acknowledge receipt of the manufacturers ventilation improvement options sheet.
r !r.
3 Date Customer Initials ;1
I hereby acknowledge that this home did contain the manufacturers "Important Health Notice" required by the U.S.
Department of Housing_and Urban Development Regulations.
Dater '�l - �z Customer. ' i y
gated . '( Retailer Signature.
WHITE/Retailer CANARY/Customer/Owner PINK/Lender GOLDENROD/Manufacturer
FORM #8-869017H
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