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16F <br /> State of Oregon <br /> .;` .� Department of Consumer and Business Services <br /> h,•d _ 11•ft <br /> Building Codes Division <br /> vrorri , <br /> N.•e '.a ; 1535 Edgewater St NW <br /> �,./ Mailing Address: PO Box 14470 <br /> 5g Salem,OR 97309-0404 <br /> (503)378-4530,FAX(503)378-4101,TTY(503) <br /> Web:mhods.oregon.gov Email:mhods.bcd@oregon.gov <br /> Manufactured Structure Transportation Permit0(e <br /> �/����-^� <br /> 19-11531-TRIP (/ / / r / <br /> This permit authorizes a qualified transporter to move the identified sections of the identified home to a destination site within the state of <br /> Oregon. The section move must occur between the Issue Date and Expiration Date specified on this permit. This permit must <br /> be carried by the transporter during the actual move.This permit authorizes movement of all home sections identified. <br /> Issue Date: 11/21/19 Not Valid After Expiration Date: 12/13/19 <br /> Applicant: Superior Home Transport LLC Phone: (541) 327-7805 <br /> PO Box 1067 Email: ritahartzell@gmail.com <br /> Jefferson, OR 97352 <br /> Home Information: <br /> Home ID: Unknown <br /> Manufacturer: SKYLINE HOMES Model: ATHENA <br /> Section Serial Number HUD Number <br /> 1 245-000-H-A100202A ORE549419 <br /> 2 245-000-H-A100202A ORE549420 <br /> • <br /> Original 550 SE BOOTH BEND RD County: Yamhill <br /> Address: MCMINNVILLE, OR 97128 <br /> Destination 4613 BRIAR KNOB LOOP County: Marion <br /> Address: SCOTTS MILLS,OR 97375 <br /> Transporter: Superior Home Transport LLC Phone: (541) 327-7805 <br /> Email: ritahartzell@gmail.com <br /> • <br /> 11/21/19 10:30 pm Page 1 of 1 C:\myReports/reports//production/01 <br /> STANDARD REPORTS/std_Trip_Permit_pr.rpt <br />