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or o State of Oregon <br /> 44'. ,�; \ Department of Consumer and Business Services <br /> Qj:f � � � Building Codes Division <br /> 11;1'11 ��'ryf t' 1535 Edgewater St NW <br /> ' `�'1'ti ua'?i z: <br /> A.4:1441.1 <br /> .• Mailing Address: PO Box 14470 <br /> 6 Salem,OR 97309-0404 <br /> (503)378-4530,FAX(503)378-4101,TTY(503) <br /> i <br /> Web:mhods.oregon.gov Email:mhods.bcd@oregon.gov <br /> Manufactured Structure Transportation Permit tp b C 3! <br /> 22-02673-TRIP �y <br /> e�jn <br /> This permit authorizes a qualified transporter to move the identified sections of the identified home to a destination site within the 5 —I 8 4 v O.� <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: 3/18/22 Not Valid After Expiration Date:4/17/22 <br /> Applicant: Superior Home Transport LLC Phone: (541) 327-7805 <br /> PO Box 1067 Email: ritahaltzell@gmail.com <br /> Jefferson, OR 97352 <br /> Home Information: <br /> • <br /> Hdme ID: Unknown <br /> Manufacturer: PALM HARBOR Model: 3104G28603D <br /> Section Serial Number HUD Number <br /> 1 PHH3100R21-14828A ORE 557636 <br /> 2 PHH3100R21-14828B ORE 557637 <br /> Original 3737 PALM HARBOR DR County: Linn <br /> Address: ALBANY, OR 97321 <br /> Destination 127 GATES HILL DR County: Marion <br /> Address: GATES,OR 97346 - <br /> Transporter: Superior Home Transport LLC Phone: (541) 327-7805 <br /> Email: ritahartzell@gmail.com <br /> • <br /> • <br /> • <br /> t <br /> 3/18/22 10:30 pm Page 1 of 1 G:\myReports/reports//production/01 <br /> STANDARD <br />