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608585
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Last modified
1/19/2024 11:00:26 PM
Creation date
1/19/2024 9:58:49 AM
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Assessor
Account Number
608585
Assessor Doc Type
Building Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
1/18/2024
MTL
072W06BA00800
Assessor Section
Manufactured Structures
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MANUFACTURER'S STATIMENT OR CERTTFICATE OF ORIGIN TO A UFACT +-JD lOII <br /> t <br /> • <br /> FIRST ASSIGNMENT <br /> MANUFACTURER:Fleetwood.Homes For Value Received,the undersigned hereby ttansfers'.this Statement of Origin and the:manufactured <br /> home described therein to: <br /> ADDRESS: , 5 P tr. -- wr ', . .urn,OR 97071 Address: <br /> and certifies that the borne is new and has not been registered in this or any other state;he also warrants <br /> (' City State,and Zip. the title of said home at time.of delivery,Subject.to the liens and encumbrances,if any,as set put below <br /> i ', r <br /> ` r Amt.Of Lien Date To Whom Due' <br /> • Address' <br /> The undersigned MANUFACTURER hereby certifies that the new manufactured home described beloiv, Dated ,' at <br /> the.property of said MANUFACTURER,has been transferreU <br /> By: <br /> this 20th day of April. 2023 on Invoice No 202372173400 Transferor(l rein Nano) Sign Here Position <br /> Dealer License(Permit)No. <br /> Before me personally appeared who by me being <br /> To JO PROPERTY GROUP LLC duly sworn upon oath says that the statements set forth above are:true and correct. <br /> Distributor.Dealer Etc. Subscribed and sworn to before Inc this day of. , <br /> Notary'Public for County,State of <br /> Whose Address is: 1700.ADAMS AVENUE SUITE212 , �: ' Notary Seal <br /> Street {' 3 SECOND ASSIGNMENT <br /> " k For Value Received,the.undersigned hereby transfers this Statement of Origin and the manufactured <br /> COSTA MESA,CA.92626 home described.therein to: . <br /> City.State,and Zip Address: <br /> and certifies that the home is new and has not been registered in this or any other state;he also warrants <br /> Trade Name: 210SP-Sandpointe-14522A Model Year. 2023 the title of said home at time of delivery,subject to the liens and encumbrances,if any,as set out below <br /> Aint.Of Lien Date Tr Whom Due Address, <br /> Model No:.210SP14522A. Body Width Ft 13'.8" <br /> Body Length Ft: 56'0" /Ft: 52'0" Dated , at <br /> Including Hitch Excluding Hitch By: <br /> Transferor(Finn Name) Sign here Position <br /> Square Feet: 710 Date of-Manufacture: 04/06/2023 Dealer License(Pemtit)No. <br /> Before me personally appeared who by me being. <br /> duly swom.upon oath says that the stateincnts set forth above are true and correct: <br /> Manufacturer's ID No: .FLE2100R23-23221 A Weight: 20,460 Subscribed and sworn"to before me this day of <br /> Manufacturer's ID Not Weight: Notary Public for '- County,State of <br /> Manufacturer's ID No: Weight: .Notary Seal <br /> Manufacturer's ID No: Weight: THIRD ASSIGNMENT <br /> For Value Received,the undersigned hercb transfers this Statement of Origin and the manufactured <br /> Manufacturer's ID No: Weight: home described therein to: <br /> Manufacturer's ID No: Weight Address: siiittemataisaw <br /> and certifies that the home'is'new and no b n, s. ,t�_� t <br /> 9 t r'tltts'ig,ray other state;he also warrants <br /> the title of said home at time of dcliv- 'iol t.j t "lances,if any,as set out below <br /> t r ie'�and emu <br /> The CORPORATION further Certifies that this was the first transfer of such new manufactured home in Amt.Of Lien Date To Whoin Due Address <br /> ordinary trade:and commerce.. <br /> Fleetwood Homes Dated' , at <br /> Corporation PT <br /> Trnnsferor(Firm Name) Sign Here Position. <br /> `` Dealer License(Permit)No. <br /> By: C`'—..)^ ;h r c Before me personally appeared who byme:being Sign Nane Title or.Position duly sworn upon oath says-hat-the statements set fotthabove arc true and comet <br /> 2655 Progress Way,Woodburn,OR 97071 Subscribed and sworn to beformmc this day of , <br /> Office f Signatory(CityStare Notary Public for County,State of <br /> O lceAddresso Si rato ) Notary Sail <br />
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