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Home My WebLink AboutBusiness License Application 1988-11-18 ,~..,- -. APPUerlON FOR TYPE I BUSINE_'CERTIFICA TE , AS A DEALER OR REBUILDER OF VEHICLES D. ORIGINAL I21..RENEWAL * 1 NAME (CORPORATION AND/0,R ASSUMED BUSINESS NAME) / ()/lf1C -7"'-"f")/,I,-"-"f"'~, e~ - 08. A ...< r S 17 t.J 7f) 2 MAIN BUSINESS LOCATION (STREET AND NUMBER) CITY .3 o~ ...s C',...rn1 Ii .s r s;: j\ It I ..,<1 h~ I., () ,.( A -ve MAILING ADDRESS _ CITY STATE ZIP CODE 3 ::Jc:r:- .,'<",,,,)7;.,' Ii Cr' ~:-:'t":I...v/;:,"'-;t'lt ol\e 97'/77 A SEPARATE SUPPLEMENTALAPPLlCA~ION (FORM 372) MUST BE COMPLETED FOR EACH ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS, 41 CHECK ORGANIZATION TYPE: I'F CORPORATION. LIST THE STATE UNDER WHOSE LAW BUSINESS IS INCORPORATED: D INDIVIDUAL D PARTNERSHIP 'g.,CORPORATION () /:)- .P r~ (\ IV' DO YOU SELL THESE VEHICLE TYPES? l~rn[u]wl NOTE: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY, PLEASE TYPE OR PRINT LEGIBLY WITH INK, ~ A J. ~...r ZIP CODE 5 MOBILE HOMES MOTOR HOMES CAMPERS DYES r:i? NO !8..1 YES 0 NO DYES ..s NO D YES TRAVEL TRAILERS MOTORCYCLES/MOPEDS CLASS I A TVS !;)YES 0 NO o YES ~NO DYES .lZJ NO SNOWMOBILES DO YOU REBUILD VEHICLES? 61 I LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS: 7INAME-<~<:7"?'1<. C 9.\."'n~(:I,'~"1" TITL':f?A'i'S....Oll:;t/T 8 I RESIDENCE ~DDRES&--, ' V '" ., ~ CITY",'" 1 ~ . ,... 2. '111\ J' e"or.-t1:> ...~e _I....,..." i ...' (, '........., 91 NAMEM --: ' ,- f) <', ~ --:::::- TITLE ~ .,.--:-- I\._H~..!; -' .', ~fl/ ':::'Wf'u.L\ f.}.Q i ...... E'c,.c( e", I'~~..... 10 I RESIDE",::?:'\~D7~SS te-1ei'U$'-.f.. $,..r IN' CITY E'v (U N( 11 [NAME TITLE 12 RESIDENCE ADDRESS ;:g. NO I'F "YES," NAME THE MAKE(S): ARE YOU A FRANCHISED DEALER? DATE OF BIf\lH / r:; II.:J /J_, STAT~, ' ~, -.l!" \ ~. DA,T50' .B,IRTH" __, 'r"J :;>,', I., \, ".. ST a'h E. DATE OF BIRTH CITY STATE I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE AND THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND TRUE, I CERTIFY THAT THE BUSINESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND IS OR WILL BE ESTABLISHED AT THE LOCATION GIVEN, 31 NAME C\ I T1TL~ I RESIDENCE TELEPHONE I 1 ..( es '1"<<::, f.. C '::::::'W II (H:;' F'd~.i" r-- A c~ ,t.: I () to;;.y -r: CIi' \:..:d 6 I? c;.', "...? ,.-;" 7 I ADDRESS. CITY, STATE, ZIP CODE C J SIGNAi~ + (J I 14 22 It) ;<:."tii:1/4",;" V"q'V'l)t,;\Ve: ~/)({('t'~OI X ~JW-<.\l--1 (i f'>.-/-l/,"l.,!1.J,,-:...,,,.;{ I AGREEMENT TO ACT AS AGENT' Any dealer who wants IO,be de.signaled 8S an Agent 01 the DiviSIOn must sign this agreement. Bylaw, all Snowmobile and Class"'fATV dealers must I . acl as aoents and must slon this aQreement. II (WE) WISH TO BE DESIGNATED AS A LIMITED AGENT FOR THE MOTOR VEHICLES DIVISION, I (WE) AGREE TO COMPLY WITH ALL APPLICABLE I LAWS AND ADMINISTRATIVE RULES AND AGREE TO HOLD THE DIVISION HARMLESS OF ANY LOSS OR EXPENSE RESULTING FROM ANY ACTS OR REPRE~ATIONS IN EXCESS OR IN CONTRAVENTION OF AGENT'S AUTHORITY, AND FROM INCIDENTAL EXPENSES DUE TO TERMINATION, I SIG~E ..(I..., 0 I TITLly..... I DATE' I I 15 X \ ~ (! ~WI.t)( ~?..< I r, ii? tV.,.. III1 C, ~. ,y- APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES 16 WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OF THE ~ CITY &<l: COUNTY OF g~iNflttd:. -, /, .::-'"..h: II CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE SEAL OR STAMP OF THE CITY OR COUNTY. 'I~ME TIT~ 17 CYm'HT~ To, HARM'lN PER101IT CXlOPDINA'IOR 181~r<fTURE I/. , . /.// / DATE :# f, j ,h!/)f"'/U fl.;ru;;? J,I1l.m. U II - /hfJ ~* IFTHIS IS A RENEWAL OF AN EXISTING CERTIFICATE, USE THE I.. I ATTACHED BILLING LIST TO CALCULATE PLATE FEES, \' "rf!i\rt~VIl" UH ::;t:AL HERE) IlPP \, U. THEBllllNGlISTMUSTBESU~ITTEDWITHYOURRENEWAlAPPLlCATION C"(iB~FT iillUll6fliLQND 51 RETY BOND WITH ALL REQUIRED SIGNATURES AND FEES TO: ;;;,;:-;r:J:t3S LICENSING UNIT. 1905 LANA AVE. NE, SALEM, OR 97314-2350 (See bottom right corner 01 page) CERTIFICATE NO: BUSINESS TELEPHONE 7~"? 0,--<'6 n COUNTY DYES RI NO DYES @ NO RESIDENCETEL.EPHONE.- '; ........1 C.t1u) ~,A;'(;.."-}.,-;"\ A ZIP CODE 9.' 'f ".... / I) .,~ RES[D~t.jCE T~~Ef.'~,ON.~ .: ~ 'I ({"h ,') f....... ,. . .... ..\ _" ZIP CODE 'f 7 "(r-..,(" R(SIDE1CE TELEPHONE ZIP CODE BUSINESS CERTIFICATE FEE (INCLUDES ONE PLATE) $96.50 ADDITIONAL LOCATIONS @ $30.00 EACH (SEE A IT ACHED SUPPLEMENTAL APPUCA TIONS) ADDITIONAL PLATES @ $11.50EACH TOTAL, $ 735-370 (5-8B) ~ Producedbv STATE PRINTING -- l~rn[u]wl /.'-... APPLlCA Tie FOR TYPE I BUSINESS ~IFICA TE ,. , ' ...' AS A DEALER OR REBUILDER OF VEHICLES ' 0 ORIGINAL [] RENEWAL * ^">~ NOTE: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY . PLEASE TYPE OR PRINT LEGIBLY WITH INK CERTIFICATE NO: 1 I NAME (CORPORATION ANDIOR ASSUMED BUSINESS NAME) BUSINESS TELEPHONE . O-RAG INDUSTRIES DBA,L & S AUTO SALES 747-0569 21 MAIN BUSINESS LOCATION (STREET AND NUMBER) . CITY . ZIP CODE COUNTY 305 South "A" Street Springfield 97477 Lane 31 MAILING ADDRESS CITY STATE ZIP CODE 255 South "A" Street Springfield OR 97477 A SEPARATE SUPPLEMENTAL APPLICATION (FORM 372) MUST BE COMPLETED FOR EACH , ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS. 41 CHECK ORGANIZATION TYPE: - .. I IF CORPORATION,LlSTTHESTATE UNDER WHOSE LAW BUSINESS IS INCORPORATED D INDIVIDUAL D PARTNERSHIP IX CORPORATION OREGON 00 YOU SELL THESE VEHICLE TYPES? 5 MOBILE HOMES MOTOR HOMES CAMPERS D YES []I NO IX] YES D NO IX] YES D NO TRAVEL TRAILERS MOTORCYCLE/MOPEDS CLASS I ATVS IX] YES D NO DYES [1J NO DYES [1J NO SNOWMOBILES DO YOU REBUILD VEHICLESi D YES IX] NO D YES Ii] NO 6 I ARE YOU A FRANCHISED DEALER? 0 YES [1] NO I LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS 71 NAME LESTER G. SWAGGART, JR. TITLE PRESIDENT D~/l~!3~TH R(E~'Q~N{E6~~E~~~5'7 8 RESIDE~~E1'(j'Df~Strace View Dr i ve CITY Funpnp S(j~TE ZIPqC704l\" 9 NAME MODESTA A. SWAGGART TITLE SECRFTARY D~/"'fJ'-:\~TH Rr~18~~CE~~~E~S~~'7 101 RESIDE~'3i'tl'Df~~race' View Drive I CITY, Euaene S6~TE ZIPq'fills 111 NAME I TITLE. DATE OF BIRTH RISIDElcETELEPHONE 121 RESIDENCE ADDRESS I CITY STATE ZIP CODE ......-. I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATlVE:ANDTHAT ALL INFORMATION ON THIS,APPLICATION IS ACCURATE AND TRUE, I CERTIFY THAT THE BUSINESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND IS.OR WILL BE ESTABLISHED .A T THE LOCATION GIVEN. 131 NAME I TITLE . I RESIDENCE TELEPHONE , LESTER C SWAGGART, JR. . PRESIDENT' . () , ( 503) 686-9357 ADDRESS, CITY, STATE, ZIP CODE l SIG~RE..tl. p (j . .;...' 14 2310 TErrace View Dr., Eugene, OR 97405 X,,~, L,~' ,;1"Il, AGREEMENT TO ACT AS AGENT: (YOU MUST SIGN'THIS AGREEMENT IF YOU SELL SNOWMOBILES OR CLASS I ATV'S) , I I (WE) WISH TO BE DESIGNATED AS A LIMITED AGENT FOR THE MOTOR VEHICLES DIVISION, I (WE) AGREE TO COMPLY WITH ALL APPLICABLE I LAWS AND ADMINISTRATIVE RULES AND AGREE TO HOLD THE DIVISION HARMLESS OF ANY LOSS OR EXPENSE RESULTING FROM ANY ACTS OR REPRESENTATIONS IN EXCESS OR IN CONTRAVENTION OF AGENT'S AUTHORITY, AND FROM INCIDENTAL EXPENSES DUE TO TERMINATION, SIGNATURE I TITLE . I DATE I 15 X .'-'- PRESIDENr-' 11/10/87 IIF "YES", NAME THE MAKE{S): I 1 1 1 I I 1 16 APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES WITH ALL: LAND USE OR" BUSINESS REGULATORY ORDINANCES OF THE' o CITY D. COUNTYOF--_._ ',"'h BUSINESS CERTIFICATE FEE (INCLUDES ONE PLATE) $96~OO . ":.'~'';' .: .. --- - II CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS I EVIDENCE OF SUCH AUTHORITY 00 AFFIX HEREON THE SEAL OR STAMP OF~' THE CITY OR COUNTY. ". -.- \17' NAME. TITLE -,. I" ...r '-. ~''''_..i;~'<'['i':-' . .~ -;;;'-M'O,'i --"-~D-';:-.r.:;:;.; ~,~'\< .' .~. ,-----,-- -" ----'T~~;~$...-:.._' .~~'-:' ----,- IGNATURE@\. _, A DATE 8'1 " , 1.wp!'"{PLACE"S~T' ;om'~; ,: 'R--(W; ::.::E'f)lII!E)I~1 (;>1 r * IF THIS IS A RENEWAL OF AN EXISTING CERTIFICATE USE THE ATTACHED BILLING LIST TO CALCULATE PLATE FEES. \ THE BILLING LIST MUST BE SUBMITTED WITH YOUR RENEWAL APPUCAnON SUBMIT' WITH ALL REdlJlRED SIGNATURES AND FEES TO: ,,'- ,,;,,...,: ."-"' . ~~ :'t' :4;'.~ BUSINESS LICENSING UNIT,,1905 LANA AVE. NE, SALEM, OR 97314.2350 7')r:;.':17n IQ.R7\ ~ ADDITIONAL LOCATIONS @ $30.00 EACH (SEE A IT ACHED SUPPLEMENTAL APPUCA TIONS). _ __.__ _.__ ADDITIONAL PLATES @.$11.ooEACH _