Laserfiche WebLink
. .. <br /> • ill <br /> AulhentIsIgn ID:760014FE-8914-4CA6.8E2D-1A236046C863 <br /> Form 17 SELLER DISCLOSURE STATEMENT ©Copyright 2012 <br /> Seller Disclosure Statement Northwest Multiple Listing Service <br /> Rev.06/12 IMPROVED PROPERTY ALL RIGHTS RESERVED <br /> Page 3 of 5 (Continued <br /> YES NO DON'T 112 <br /> E, Are all plumbing fixtures,including laundry drain,connected to the KNOW 113 <br /> sewer/on-site sewage system? PV ❑ ❑ 114 <br /> If no,please explain: 115 <br /> *F. Have there been any changes or repairs to the on-site sewage system? ❑ fl$'' ❑ 116 <br /> G. Is the on-site sewage system,including the drainfield,located entirely 117 <br /> within the boundaries of the property? ❑ lfr ❑ 118 <br /> If no,please explain: • - I l# <br /> *H. Does the on-site sewage system require monitoring and maintenance services more 120 <br /> frequently than once a year? ❑ ❑ 121 <br /> NOTICE: IF THIS RESIDENTIAL REAL PROPERTY DISCLOSURE IS BEING COMPLETED FOR NEW CONSTRUCTION 122 <br /> WHICH HAS NEVER BEEN OCCUPIED,SELLER IS NOT REQUIRED TO COMPLETE THE QUESTIONS LISTED IN ITEM 4 123 <br /> (STRUCTURAL)OR ITEM 5(SYSTEMS AND FIXTURES). 124 <br /> 4. STRUCTURAL 125 <br /> *A. Has the roof leaked within the last 5 years? ❑ er 0 126 <br /> *B. Has the basement flooded or leaked? ❑ Igt". ❑ 127 <br /> *C. Have there been any conversions,additions or remodeling? (tV Cl ❑ 128 <br /> *(1)If yes,were all building pemiits obtained? , (4i''' ❑ ❑ 129 <br /> *(2)If yes,were all final inspections obtained? W/' ❑ ❑ 130 <br /> D. Do you know the age of the house? ❑ ❑ Er- 131 <br /> If yes,year of original construction: /7 0 • 132 <br /> *E. Has there been any settling,slippage,or sliding of the property orr its improvements? ❑ er ❑ 133 <br /> *F. Are there any defects with the following:(If yes,please check applicable items and explain.) ❑ ❑ 134 <br /> ❑ Foundations U Decks Cl Exterior Walls 135 <br /> ❑ Chimneys ❑ Interior Walls ❑ Fire Alarms 136 <br /> ❑ Doors ❑ Windows 0 Patio 137 <br /> ❑ Ceilings ❑ Slab Floors ❑ Driveways 138 <br /> ❑ Pools ❑ Hot Tub ❑ Sauna 139 <br /> ❑ Sidewalks ❑ Outbuildings ❑ Fireplaces 140 <br /> Cl Garage Floors U Walkways ❑ Wood Stoves 141 <br /> ❑ Siding ❑ Other 142 <br /> *G. Was a structural pest or"whole house"inspection done? ❑ ❑ I 143 <br /> If yes,when and by whom was the inspection completed? 144 <br /> 145 <br /> H. During your ownership,has the property had any wood destroying organism or pest infestation? ❑ V ❑ 146 <br /> I. Is the attic insulated? I8' ❑ ❑ 147 <br /> J. Is the basement insulated? Iir- ❑ ❑ 148 <br /> 5. SYSTEMS AND FIXTURES 149 <br /> *A. If any of the following systems or fixtures are included with the transfer,are there any defects? 150 <br /> if yes,please explain: 151 <br /> Electrical system,including wiring,switches,outlets,and service ❑ ❑ 152 <br /> Plumbing system,including pipes,faucets,fixtures,and toilets CI 153 <br /> Hot water tank ❑ id" ❑ 154 <br /> Garbage disposal ❑ f' ❑ 155 <br /> Appliances ❑ l ' ❑ 156 <br /> Sump pump ❑ a ❑ 157 <br /> Heating and cooling systems ❑ lie ❑ 158 <br /> Security system❑Owned❑Leased ❑ ECK ❑ 159 <br /> Other Cl Or. ❑ 160 <br /> *B.'If any of the following fixtures or property is included with the transfer,are they leased? 161, <br /> (If yes,please attach copy of lease.) 162 <br /> Security System ❑ gr ❑ 163 <br /> Tanks(type): ❑ it ❑ 164 <br /> Satellite dish ❑ lid'"' ❑ 165' <br /> Other: ❑ " ❑ 166 <br /> oftS LER S INITIALS aSELLER'S INITIALS Date <br />