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606904
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Last modified
9/25/2023 2:58:49 PM
Creation date
9/25/2023 2:58:48 PM
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Assessor
Account Number
606904
Assessor Doc Type
Trip Permit
Doc Type Date
9/21/2023
MTL
082W06AC02600
Assessor Section
Manufactured Structures
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SECTION 6 . ', NEW OWNER-ACKNOWLEDGEMENT(One name per box)'; <br /> '` `, ❑Person ❑Q Business ❑Trust ❑Guardian <br /> r" Legal Name:CPI SUNDIAL OWNER LLC Phone: <br /> p,�o (last,first,middle) <br /> %I"'" ' Mailing Address:18150 SW BOONES FERRY ROAD <br /> City:PORTLAND State:OR ZIP:97224_ ... <br /> 0A Email: <br /> L I , Right of ❑Yes ❑No <br /> 2 ': Survivorship: <br /> Signature: Wt. <br /> �� Date:• 9 „it.4_3 <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> , Legal Name: Phone: <br /> (last,first,middle) <br /> Mailing Address: <br /> City: State: ZIP: <br /> QQi" Email: <br /> hi,! - Right of <br /> Survivorship: ❑Yes ❑No <br /> Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> ,en `' Legal Name: <br /> (last,frst,middle) Phone: <br /> "a Mailing Address: . <br /> , City: State: ZIP: <br /> `0 Email: <br /> ;W ;' Right of <br /> ❑Yes El No <br /> E ',,�,'; Survivorship: <br /> `''r Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> Legal Name: — __ _—_ <br /> RI' Phone: <br /> CC (last,first,middle) <br /> I" - Mailing Address: <br /> City: State: ZIP: <br /> Email: <br /> •vP Right of <br /> '2 Survivorship: ❑Yes ❑No <br /> Signature: Date: <br /> NEW OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the sale or change <br /> of ownership.I understand that the home cannot be relocated without first completing this application and purchasing a trip permit <br /> from the Building Codes.Division or through one of its county agents. <br /> I understand that the seller/owner is responsible for submitting this application within 30 days after the close of the sale,and that all <br /> buyers and sellers will be notified by mail when the application is approved.If the application has not been submitted after 30 days,I <br /> may complete the filing under ORS 446.64(1). <br /> I understand that each lessor,mortgagee,trust-deed beneficiary,lien holder of record,and security interest holder must be listed on <br /> this notice.If none are listed,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens. <br /> Page 3 <br />
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