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o F State of Oregon <br /> j*:r i' Department of Consumer and Business Services <br /> Building Codes Division <br /> m1; .rrurarGi:iZ 1535 Edgewater St NW <br /> \**`f ; Mailing Address: PO Box 14470 <br /> L s 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 /> 21-12658-TRIP IN 3q.--7 <br /> This permit authorizes a qualified transporter to move the identified sections of the identified home to a destination site within the 5 Q8,0” <br /> state of Oregon. The section move must occur between the Issue Date and Expiration Date specified on this permit. <br /> This permit must be carried by the transporter during the actual move.This permit authorizes movement of all home sections <br /> identified. <br /> Issue Date: 12/9/21 Not Valid After Expiration Date: 1/6/22 <br /> Applicant: DOUGS MOBLE HOME SERVICE INC Phone: (503) 799-0539 <br /> 12692 FRY ROAD Email: DUGWALTON@AOL.COM <br /> AURORA, OR 97002 <br /> • <br /> Home Information: <br /> Home ID: 378999 <br /> Manufacturer: PALM HARBOR Model: Unknown <br /> Section Serial Number HUD Number <br /> 1 PHH3100R1411183A <br /> 2 PHH3100R1411183B <br /> Original 19792 S YOUNG RD County: Clackamas <br /> Address: MOLALLA, OR 97038 <br /> • <br /> Destination 255 DETROIT AVE County: Marion <br /> Address: DETROIT,OR 97342 ' <br /> Transporter: DOUGS MOBLE HOME SERVICE INC ' Phone: (503) 799-0539 <br /> Email: DUGWALTON@AOL.COM <br /> 12/9/21 10:30 pm Page 1 of 1 G:\myReports/reports//production/01 <br /> ' STANDARD <br />