HomeMy WebLinkAboutMFG Home - BLD Application - 11/21/2006 RETURN ADDRESS
PACIFIC NORTH4JEST TITLE
9927 MICKELBERRY ROAD NW
......................................-.........................-----------..........------....----•-----••-••••-••-•--..._.......-•--
SILVERDALE, WA. 98383
31051376
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I MANUFACTURED HOME
1ffns/ r APPLICATION ®TITLE ELIMINATION
inV OTRANSFER IN LOCATION
Anyone who knowingly makes a false statement of a material fact is guilty nREMOVAL FROM REAL PROPERTY
of a felony, and upon conviction may be punished by a fine,imprisonment,or both.(RCW 46.12.210)
MANUFACTURED HOME
1PO/PLATE NUMBER :YEAR I MAKE 7LENGT)1jWIDTH(FEET)
VEHICLE IDENTIFICATION NUMBER(VIN)
%084017 : 1994 LIBER14 X 66 09L26976
LAND LEGAL DESCRIPTION ON PAGE
REAL PROPERTY TAX PARCEL NUMBER
MANUFACTURED HOME WILL BE IN AFFIXED L REMOVED 1 12331-51-00082
LOT BLOCK PLAT NAME OR SECTION/TOWNSHWIRANGE OUARTER/OUARTER SLCTICM
92 BEARD'S COVE No. 8
GRANTOR(S) REGISTEREDILEGAL OWNER(S) ADDITIONAL NAMES ON PAGE
COUNTY NUMBER i NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS
1v1AS0N
NAME OF REGISTERED OWNER Drivers L1CPT15E' — OOLCUSTOMERACCOUNrNUMBE
MICHAEL GAWAINE GUY _ 100C26 9 413 C_314,
NAME OF ADDITIONAL REGISTERED OWNER DOL CUSTOMER ACCOUNT NUMBER
AUURESS CITY STATE ZIP CODE
140 NE CAPTAIN HOOK DRIVE BELFAT_R WA 98528 _
NA.ML OF LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER
EAGLE HOME MORTGAGE, LLC
NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT Nl1MBEP.
ADDRESS CITY STATE ZIP CODE
10510 NE NORTHUP WAY # 300 KIRKLAND WA 980.33
GRANTEE _
NAME
I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I I WE AMIARE THE REGISTERED OWNER(S)OF THIS
VEHICLE AND THIS INFORMATION IS ACCURATE:
Signature of Registered Owner and Title,IF APPLICABLE_/h 'j"X"I
.Signature of Additional Registered Owner and Title, IF APPLICABLE
NOT%�COSTAMP NOTARIZATIONICERTIFICATION FOR REGISTERED OWNER(S) SIGNATURE
��Y S. If It
I State of Washington Signed or attested
��:�SsiONI'I�,�''y County of .._. _1. -`n11i- before e n
#
.70 �OTA�� m /� by MICHAEL GAWAINE GUY ry-_----.•------ Signature
m' �T PRINT NAME OF REGISTERED OWNER
i � � y yi� ZTY
OR GE
N s
7 '% 7 �g; 2 by --------- --- -- ---— --- -------- - --s------ ..... ' .•-- -----..A� �. .
/ �/I 7-'rj_�Cj , 0 _I PRINT NAME OF REGISTERED UWNER PRINTED NAME OF NOT Y
1 Illl ✓A S 11 County/Offjcello�R =
y G�� I Title NOTARY-`---- _ AND: healer No.oF�_ _/_
Is I DEALERSHIPPOSITIOWAGENT/NOTARY tary Expiration Uale
TITLE 60 PANY 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: the manufactured home has been affixed to the real property as described. _
E3 a building permit has been issued for this purpose and the attachment will be Inspected upon completion.
--
BLDG PERMIT OFFICEIPHO14E q BLDG PERMIT M
NAME TYPEO OR PRINTED) �- 7- I 7L
i BLD93-01427 --
v"C �
DATE
SIGN UWP O IT ION
TD-420-729MANUF HOME APPL(R/2K12)O ( )Page1 2