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606908
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Last modified
9/5/2023 10:04:08 AM
Creation date
9/5/2023 10:04:07 AM
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Assessor
Account Number
606908
Assessor Doc Type
Trip Permit
Doc Type Date
8/24/2023
MTL
082W06AC02600
Assessor Section
Manufactured Structures
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• 5D. 2( D. Ave ' t 11' LI. Se 97317 <br /> SECTION 1 ' NATURE OF FILING(deck all that apply) <br /> 0 New home to MHODS g er o•' on ) <br /> [ s fornesateN----- co di ��>t n�r ed t <br /> pk_Setacitribt srsttange e • r • pe status 0 Trip Permit <br /> n er i en nce Ot f)cird is ote): <br /> SECTION 2 APPLICANT INFORMATION(please print) • <br /> 0 Dealer/Seller ❑ Lender ❑Escrow/Title Agent ❑Owner/Buyer ❑Legal Representative <br /> Name:COMMONWEALTH HOMEOWNER SERVICES Phone:503-244-2300 <br /> (/irst,middle,last) <br /> Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR ZIP:97227 <br /> Email:MELISA.COOK@CWRES.COM <br /> SECTION 3 ' ` 'HOME INFORMATION(information In bold is required) <br /> Home ID#: J E iv OR No Home ID: 0 New Iiomc ❑Out of state home 0 Leaving County Deed Records <br /> Manufacturer:SKYLINE (0.06 902 <br /> Model:ARLINGTON Year:2023 <br /> Serial Number(s) HUD Label Number(s)*Required if new home <br /> 245-000-H-A101454A ORE 560224 <br /> 245-000-H-A101454B ORE 560225 <br /> #of Sections: 2 Sq.footage: 1394 Bedrooms: 2 Bathrooms: 2 <br /> Roofing type: COMP Siding type: Cement Panel Heating type: ELECTRIC Cooling type: NONE <br /> Date of sale. 5-31-23 Sale price: $94,723 Includes land: El Yes lI No <br /> (if applicable) <br /> SECTION 4 .__ DEALER INFORMATION(leave blank If no dealer) <br /> License#:MSD508 <br /> Name:COMMONWEALTH HOMEOWNER SERVICES, INC. <br /> (first,middle, last) <br /> Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR ZIP:97224 <br /> Email: Phone: <br /> I hereby declare this manufactured structure is free and clear of all mortgages,deeds of trust,security interests,and liens.I have the <br /> legal right to sell this manufactured structure or my interest in it. The information listed is true to the best of my knowledge and <br /> belief,and I understand it can be used as evidence in court and is subject to a penalty of perjury. <br /> Signature: �'� Date: V ic)'243 <br /> ,SECTION 5 HOME LOCATION. <br /> Current Address:2445 PACIFIC BLVD SW <br /> City:ALBANY County:LINN State:OR Zip:97321 <br /> Park Name: (f applicable) ■❑This is a dealer lot or storage facility <br /> MI This home is being moved to a new location Complete the section below <br /> New Address:2232 42ND AVENUE SE, SP.#119 <br /> City:SALEM County:MARION State:OR Zip:97317 <br /> Park Name: (if applicable) SUNDIAL MHP ❑This is a dealer lot or storage facility <br /> Transporter Name:NEWMAN'S MOBILE HOME TRANSPORT Phone: 503-932-5142 <br /> Address:PO BOX 236 City: SILVERTON State: OR <br /> Email: <br /> Page 2 <br />
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