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i.� <br /> OF- O State of Oregon <br /> ytiay. Department of Consumer and Business Services <br /> •%t4 *.•\ , Building Codes Division <br /> �rrsr� : <br /> '�; ;; / 1535 Edgewater St NW <br /> :'�' Mailing Address: PO Box 14470 <br /> 869 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 /> 21-13256-TRIP <br /> This permit authorizes a qualified transporter to move the identified sections of the identified home to a destination site within the <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: 12/28/21 Not Valid After Expiration Date: 1/26/22 <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,ALBANY Model: 72ING28703AH21 <br /> Section Serial Number HUD Number <br /> 1 ALB041244ORA <br /> 2 ALB041244ORB <br /> Original 2445 Pacific BLVD SW County: Linn <br /> Address: Albany, Oregon 97321 <br /> Destination 8726 70th SE AVE County: Marion <br /> Address: Turner,OR 97392 - <br /> Transporter: Lori Simon Phone: (541) 928-1471 <br /> Email: Isimon@jandmhomes.com <br /> 12/28/21 10:30 pm Page 1 of 1 G:\myReports/reports//production/01 <br /> STANDARD <br />