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�� State of Oregon <br /> (--- <br /> isi�ifa �'\\1 Department of Consumer and Business Services <br /> lis;;\2 Building Codes Division <br /> 1"'•t-..O..,•Z 1535 Edgewater St NW <br /> V.; <br /> 8 r Mailing Address: PO Box 14470 <br /> 9• Salem,OR 97309-0404 <br /> (503)378-4530,FAX(503)378-4101,TTY(503) <br /> Web:mhods.oregon.gov Email:mhods.bcd@oregon.gov <br /> Manufactured Structure Transportation Permit <br /> 21-02531-TRIP (l/ 0 On 5 <br /> This permit authorizes a qualified transporter to move the identified sections of the identified home to a destination site within the state of <br /> Oregon. The section move must occur between the Issue Date and Expiration Date specified on this permit. This permit must <br /> be carried by the transporter during the actual move.This permit authorizes movement of all home sections identified. <br /> Issue Date: 3/11/21 Not Valid After Expiration Date: 4/10/21 <br /> Applicant: J &M Homes, LLC Phone: (503) 908-8166 <br /> 12901 SE 97th Ave #100 Email: tmelchior@jandmhomes.com <br /> Clackamas, OR 97015 <br /> Home Information: <br /> Home ID: Unknown <br /> Manufacturer: CMH MFG WEST, HERMISTON Model: 55CRC28483AH21 <br /> Section Serial Number HUD Number <br /> 1 HER0327860RA <br /> 2 HER0327860RB <br /> Original 400 W Elm AVE County: Umatilla <br /> Address: Hermiston, OR 97838 <br /> Destination 35175 North Fork SE RD County: Marion <br /> Address: Lyons,OR 97358 <br /> Transporter: J &M Homes, LLC Phone: (503) 908-8166 <br /> Email: tmelchior@jandmhomes.com <br /> 3/11/21 10:30 pm Page 1 of 1 C:\myReports/reports//production/01 <br /> STANDARD REPORTS/std_Trip_Permit_pr.rpt <br />