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\ � <br /> � ���� / [� �� <br /> __��� �� �� /^�/�) �/ \ <br /> . ^ ' .~ <br /> ��a����facti ��� ^~ � 7p�KK� Permit � K�K��K���`�D8 —'- . <br /> � (mxn| o[C000umcr and Business Services <br /> . ' <br />� |Building Codes Division / <br /> 153 5 St. NYV. S�\on. 0rcgox ^ {` ionc: 503']78�53U ^ [xz: 5O3-]7S'4|0! - | <br /> Web: 0rcg0V.g0,/hcd " [\U8i[ <br /> ' xnn hc»ubn Uc� with x rx|i� |oz c«��6cuxnx from (hc coon(y io «N�h Uu homu x concnUy|o:x cJ <br /> xnn ��Uxmonni xuon / vv � � , <br /> -"� 6 lJi A�D \� oixm\c /hu( |m� �uu�cu|iU�d6« Uumxv ) ooU� <br /> ;bsWe \zm0ucounydnhmoxi" mnnog (o� 'x / xxcr / cx m .^ '}� <br /> �»obnlKtdbekrCduc' ��iood8c9roriJc6bv \\u0000(yx( \bc(imco[ccriDcxiioo. <br /> ' <br /> ���[�[���l[ ���������������KJ — -- ] <br /> ' ~ ' ' ' <br /> - <br /> Z]y}�221 Nbm Street, Suke2030 Lo�Nkm. CA94O23 <br /> ~'�'state.� -- --------- ----- ---- ---� ---�--�------- -----1 <br /> .�� / <br /> l�[nm�:G50��G��17 <br /> 'bnall ehneN s@�amberhomes.us <br /> /�nnom�eomesus <br /> ` -_ � <br /> TRANSPORTER INFORMATION <br /> ` Superior Horne ''~^~'�` ^LC <br /> cily.state. and ZlP)�257N0hS(Ja�emon, OR97352 <br />� <br />� }Phonc541'-32T'78U5 office <br /> Emu}�ntyhor�eU��moV�om _ - <br /> ' . <br /> HOME INFORMATION <br /> Honic |D numhcr(ifknm`n): DkJV X-plate number(// n* <br /> _NI unu[ucmmcFleetwood Modc :230BM148638 ' <br /> BCD label uundeo1DA25SOO2 <br /> Scru|nunbco:FLE230|D21'37121A — <br /> ADDRESS INFORMATION ' <br />� _Current location (including city, skUo.ZIP):2611 E Comstock Ave, Nampa, |D83687 County:canyon _ <br />� IManufacmro] 6omc park nunic. ifapplicable: <br /> [�0cccoudcuicrlo4 Dcu|croxmc� <br />� ~ � � <br />� KOu|'of-m*tc dealer lot Dcnkznxmcxndcoo�ciink`ona�ion�ReekwoudHomes. 208.5U5.82�O / <br /> — ---- | r <br /> :Placement |ougiun(including city, s/x/c`ZUP):4S158wuQ|e RD NE lot 54 "w�en.nm »» <br />� | <br /> . Manufactured ]ionic park nnne` 11'xpp|icu6 c Sunset Village <br /> nDrcgoo dealer lot Deakrmmc <br /> _ <br /> Applicant signature: <br /> � <br /> Amount <br /> - ---- 00 <br /> ` Trip y,,o,it(per section) S5.0V<70�\l'|\Y5) .-- <br /> ' TOTAL S <br /> Make check or money order payable to Department of Consumer and Business Services. If paying by credit card.applicant <br /> most sign credit card ink`rmuhnn box. Donot send cash.Secure fax: 503447'2333 <br /> [] ' EgMaslerCard [l Discover P|` mc:(},bj)d|) 2-7L|\0 '--Department use only ----- <br /> � u <br /> i $ <br /> CardhoNc,sixnuvre Amount <br /> wumco[cardholder m shown vo credit card <br /> ' -- — E`p/cx.wo | <br /> .[pdvo�rmm»c . <br /> 440-5z25(/01/7/cox} <br />