HomeMy WebLinkAboutApplication APPLICANT 5/14/2021ICity of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPiI1NOF1
(City Staff completes form)
PermitType
Dept of Motor Vehicles -New: ❑
Land Use Compatibility Statement: ❑ City:
Dept of Motor Vehicles -Renewal:
Project Information
Applicant: Emmett M. Smith
Zoning Verification Letter: ❑ UGB: ❑
Phone: 541-337-0782
Company: Emmett's Car Finder
Email:
Address: 385 54th Street, Springfield, OR 97478
Property Owner: Jimmy & Marsha Smith
Phone:
Company:
Cell:
Address: 385 54th Street
ASSESSOR'S MAP NO: 17-03-33-13
TAX LOT NO(S): 3701
Property Address: 385 541h Street
Description of Proposal:
Home Occupation DMV License
Record Information
Record No: 811-21-000117-TYP1
Date Received: May 14, 2021
Application Fee: $343.00
Technical Fee: $17.15
TOTAL FEES: $360.15
Assigned Planner:
Revised 1 t.2.11 ld
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APPLICATION FOR
THREE YEAR VEHICLE DEALER CERTIFICATE
AS A DEALER OR REBUILDER OF VEHICLES
CUSTOMER NUMBERXm
EFFECTVE DPTE
EXPIRATION DATE
DEALER NUMBER
❑ ORIGINAL
❑ RENEWAL
If this is a renewal, do not complete the fee information. Use the attached
CERTIFICATE FEE
billing list to calculate your fees. The billing list MUST be submitted with your
a
renewal application.
LATE FEE
Original Certificate (Includes one plate)................................. $1,187.00
SUPPLEMENTALS
Additional Locations @$350.00..................... $
RENEWAL PLATES
(Supplemental Application Form 735-372 required for each
location) $
ADDITIONAL PLATES
Additional plates 12" x 6" or 7 x 4"-9$54-00 ...
TOTAL $
TEMPORARY PLATES
(Two sizes, standard and small, available) TOTAL = $
BUSINESS NAME AND ADDRESS Any alteration of Line 3 voids location approval.
LE�rAME OF PPLICANT (OWNER,PAPTNERSWP, LLC OR CORPORATION NAME)
FEDERAL ID NUMBER (FEIN)
OREDON REOISTRV rQF LLC OR CORPORATION)
Ii�W e
BUSINESS NAME (OF ASSUMED BUSINESS NAME, u- IN REGISTRY NO.)
OREGON REGISTRY NO.
BUSINESS TELEPHONE
,
SIN
501-337-0792-
BUSIN LOCATIONm ANO NUMBER)
CITY
ZIP E
COUNTY
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nh
MAILING ADDRESS
Crry
STATE
CODE
EMAIL
TYPE OF OPERATION
eeumwabon.at fie sWe uMer
CHECK ORGANIZATION TYPE: ❑ Individual ❑ Partnership ❑ LLC
whkh business is inc.Wrateo:
❑ Corporation:
I /we primarily sell: ❑ New Vehicles X Used Vehicles
I /we are a franchise dealer: ❑ Yes ® No If `Nes," name the makes y
I/ we sell NEW RECREATIONAL VEHICLES: X Yes ❑ No
IF"YES/'SERVICEFACILITYLOCATION (STREETANDNUMBER)
CITY
ZIPCODE
LOCATION APPROVAL (If renewal, required only if dealer is changing business location)
Certification of local zoning. ORS 822.005 requires a vehicle dealer certificate, unless exempt under ORS 822.015, for any person
who:
(a) Buys, sells, brokers, trades or exchanges vehicles either outright or by means of any conditional sale, bailment, lease,
security interest, consignment or otherwise; OR
(b) Displays a new or used vehicle, trailer, or semitrailer for sale; OR
(c) Acts as any type of agent for the owner of a vehicle to sell the vehicle or acts as any type of agent for a person interested
in buying a vehicle to buy a vehicle.
THE CERTIFICATION BELOW IS TO BE COMPLETED BY THE LOCAL ZONING OFFICIAL. The approval below should be based
upon whether the applicant can do ANY of the activities listed in (a) through (c) above under applicable ordinances, at the location
of the business given on Line 3. Pursuant to ORS 822.025, applicant shall meet requirements below.
As the zoning official for the jurisdiction where this business is located, I verily by my signature that the location of this business as stated an this application
complies with any land use ordinances of the jurisdiction pursuant to ORS 822.025.
E] CITY OF: ❑ COUNTY OF:
TELEPHONENUMBER
(S-l1 /� 3 7 07B
PRINT NAMEr
S
TITLE
li rj e /
SIGNATURE
DATE
X
17 Race aWmp ®r soW here V
❑ Check box if restrictions on the location
approval are in an attached letter from
the zoning authority.
iRL6TL1fF61RE Paue1
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21
BUSINESS LOCATION INFORMATION:
Property is (check one): 50OWNED ❑ LEASED/ RENTED: LEASE OR RENTAL PERIOD:
If property is "Leased / Rented" complete the following:
PROPERTY OWNER'S FULL NAME \
TEL PHONE NUMBER
PROPERTYUWNERSAUDHESS
CITY
STATE
I ZIP CODE
(Be sure to attach a separate sheet to show additional owners.)
e List the primary owner, partners, LLC members or corporate officers below.
e If member of a limited liability Company (LLC) is a corporation, the president must provide information below-
41 If a partner of a partnership is a corporation, the president must provide information below.
e If Corporation or LLC, the Oregon registered agent name and addresses are required below.
OREGON REGISTERED AGENT NAME
TELEPHONE NUMBER
iw
(9 ) -07g
OREGONflEGIGTEREDAGENT MAILING ADDRESS
CITYS&—Ize
STATE
I
I ZIPDE
Ce
1 27V7
OREGON REGISTERED AGENT STREET ADDRESS
CITY
STATE
I ZIP CODE
PRINCIPAL'S DEALER HISTORY
Information on the principals of this business is requested under Oregon Revised Statutes (ORS) 822.035 and Oregon
Administrative Rule (OAR) 735-150-0024.
OAR 735-150-0010(28) defines the principal of a dealership as "an owner, partner, Corporate officer or other person who
Controls or manages the business organization or employees or agents of the business organization." "Principal"
includes all owners, partners, members, Corporate officers, or directors.
Please provide the following information about all owners listed on this application and other principal(s) of the
business:
Has any principal of this dealership been financially or operationally involved in any jurisdiction, including Oregon,
with a vehicle dealership whose Certificate or right to apply for a certificate was revoked or is currently suspended?
NO ❑ YES, revoked or is currently suspended. If "YES," complete Section 19.
NAME OFDEALERSHIP
PRINCIPAL'S NAMES)
DEALER CERTIFICATE NUMBER
STATE WHERE SUSPENDED I REVOKED
DATE OF SUSPENSION I REVOCATION
EXPIRATIONOFSUSPENSION
Has any applicant ever been an owner or principal on a vehicle dealer certificate in Oregon (excluding Current application)?
;KNO ❑ YES: If "YES," complete Section 21.
NAME OF DEALERSHIP I
� �/
PRIN IPAL'S NAMEIS) r
Ste,
�- c r e-�
��
DEALER CERHFIC TE NUMBER
OWNER INFORMATION AND CERTIFICATION
False certification is a Class B misdemeanor under ORS 162.085 and is punishable by six months in jail, a fine of up to
$2,500 or both. In addition, civil penalties and OMV sanctions against you or your dealer certificate may be imposed.
With this in mind.. .
I CERTIFY...
e 1 am an Owner, a partner, limited liability company member or corporate officer of this dealership and my name is
listed on this application.
e ALL information on this application is accurate and complete.
e 1 deal in vehicles and conduct business at the location given on Line 3 of this application.
e The dealership will comply with all applicable laws and administrative rules.
e I/we hereby certify that the persons named in this application are not acting as the alter ego, in the place of, or on
behalf of, any other person or persons in seeking this certificate.
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DMV AGENT AGREEMENT
The dealer is granted the following options as a DMV agent and must comply with all applicable
laws and administrative rules. The dealer is not obligated to perform any of these options except
as required by law. *Snowmobile dealers must act as DMV agents for Oregon residents.
• *Accept applications and fees for titles and registrations of vehicles they sell, and only charge fee
amounts set by Oregon Revised Statutes (ORS) and Oregon Administrative Rules (OAR).
• Perform vehicle identification number inspections on vehicles they sell, except a dealer may not
perform an inspection under those situations described in OAR 735-022-0070(6)(A-G).
• Issue temporary registration permits for unregistered vehicles they sell.
• Agent status can be placed on probation, suspension or revoked as allowed in OAR 735-150-0120
for noncompliance of any ORS of the Oregon Vehicle Code.
• By signing this application on Page 3, the dealer becomes an agent of DMV and agrees to comply
with all administrative rules and all dealer related statutes in the Oregon Vehicle Code.
OWNERSHIP INFORMATION
PRINT NAME OF OWNER, PARTNER, LLC MEMBER OR CORPORATE OFFICER
e.sal/
TITLE
TELEPHONE NUMBER
7-oiBZ
DATE OF BIRTH
\-1'1-7�
DRIVER LICENSE NUMBER
1Sb15
STATE OF ISSUANCE
EMAIL
RESIDENCE ADDRESS
CRY
STATE
ZIP CODE
MAILING ADDRESS (IF DIFFERENT)
Cm'
STATE
ZIP CODE
CEMIFYINGSIGN
X
RE,OCPO"WNER SHOWN LINE22ABOVE
rvt_
DATE
PRIM NAME OF OWNER,PARTNER, LLC MEMBER OR CORPORATE OFFICER
TITLE
TELEPHONENUMBER
DATE OF BIRTH
DRIVER LICENSE NUMBER
STATE OF ISSUANCE
EMAIL
RESIDENCE ADDRESS
CITY
STATE
ZIP CODE
MAILING ADDRESS (IF DI FFEREM)
CRY
STATE
ZIP CODE
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 27 ABOVE
X
PATE
PRINT NAME OF OWNER. PARTNER, LLC MEMBER OR CORPORATE OFFICER
TITLELEPHONE
TENUMBER
DATEOFBIRTH
DRIVER LICENSE NUMBER
STATE OF ISSUANCE
EMAIL '
RESIDENCE ADDRESS
CITY
STATE
ZIP CODE
MAILING ADDRESS (IF DIFFERENT)
CITY
STATE
ZIP CODE
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 32 ABOVE DATE
X
PRINT NAME OF OWNER,PARTNER, LLC MEMBER OR CORPORATE OFFICER
TITLE
TELEPHONENUMRER
DATE OF BIRTH
DRIVER LICENSE NUMBER
STATE OF ISSUANCE
EMAIL
RESIDENCEADDRESS
CITY
STATE
ZIP CODE
MAILING ADDRESS (IF DIFFERENT)
CITY
STATE
ZIP CODE
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 37 ABOVE
X
DATE
Page (Over for Photo ID...)
Please attach (staple) copies of ALL owners, partners, LLC members or corporate officers
valid government photo ID's. If the residence address on the photo ID is different than the
residence address listed on Page 3, submit a statement explaining why the addresses do
not match.
Copy must be legible.
Submit fees and these items to DMV together:
• Application (Form 735-370)
• Bond (Form 735-370B)
• Certification of Liability Insurance (Form 735-3706) or Certification of Exemption (Form
735-7024)
• Billing List (renewals only)
• Supplemental Application (if more than one location) (Form 735-372)
• Certificate of education completion or Certification of Exemption from Dealer Education
Requirements (Form 735-370C).
• Request for DMV location requirement exemption if applicable.
• Copies of ALL owners, partners, LLC members or corporate officers valid government -
issued photo ID's.
To: DMV Business Licensing Unit Phone: (503) 945-5052
1905 Lana Ave NE Business office hours are: 8:00 a.m. —4:30 p.m. Monday—
Salem OR 97314 Friday, except for Thursdays 9 a.m. — 4:30 p.m., (closed
holidays).
INSTRUCTIONS FOR COMPLETING AN
ORIGINAL APPLICATION FOR THREE YEAR VEHICLE DEALER
a a CERTIFICATE AS A DEALER OR REBUILDER OF VEHICLES
OFFICE HOURS for Business Licensing Unit, in the Salem DMV Headquarters office, business hours are
8:00 a.m. — 4:30 p.m., Monday through Friday except Thursdays 9 a.m. — 4:30 p.m., (closed holidays).
READ ALL PARTS of the application before completing it. Your application will be returned to you if any
part is incomplete or missing.
SUBMIT THESE ITEMS TOGETHER: MAIL TO:
✓ YOUR COMPLETED APPLICATION (Be sure you provide copies of ALL DMV BUSINESS LICENSING UNIT
owners, partners, LLC members or corporate officers official photo ID's) 1905 LANA AVE NE
✓ PLATE BILLING LIST (Renewal applications only) SALEM OR 97314
✓ SURETY BOND (Be sun: you sign it!)
✓ LIABILITY INSURANCECERTIFICATEPhone: (503) 945-5052
✓ EDUCATION CERTIFICATE from a DMV approved provider or a Website: www.oregondmv.com
HOME OCCUPATION INFORMATION
Reference SDC 4.7-165
A home occupation is a lawful activity carried on within a dwelling or accessory structure
by a member or members of the family who occupy the dwelling. A home occupation is
permitted provided that:
A. The primary use of the building is a dwelling;
B. The occupation is a secondary use that does not significantly affect the
residential character of the dwelling or neighborhood; and
C. Compliance with the following standards shall occur at all times:
1. There shall be no display which would indicate from the exterior
that the building is being used for any purpose other than a
residential dwelling.
2. There shall be no outside storage of materials visible from public
property or adjacent private property.
3. Mechanical equipment, unless compatible with residential
purposes, shall be prohibited.
4. There shall be no offensive noise, vibration, smoke. dust, odors,
heat or glare noticeable at or beyond the property line resulting
from the home occupation.
5. The home occupation shall not create hazardous traffic conditions
or utilize on -street parking of nearby properties.
6. If the proposed home occupation requires any modification to the
dwelling or accessory structure of a nature that is not typically
found in a residential district, the proposed home occupation is
considered inappropriate and prohibited.
7. No merchandise, other than what is produced on-site shall be sold
to the public from premises.
Homeocaapafim,l.f mll.I.UB
BPR
CITY OF SPRINGFIELD, OREGON
225 Fifth Sheet#Sorinefield OR 97477*PIi(541)726-3753+FAX(54D726-3759
HOME OCCUPATION INFORMATION
Reference SDC 4.7-165
A home occupation is a lawful activity carried on within a dwelling or accessory structure
by a member or members of the family who occupy the dwelling. A home occupation is
permitted provided that:
A. The primary use of the building is a dwelling;
B. The occupation is a secondary use that does not significantly affect the
residential character of the dwelling or neighborhood; and
C. Compliance with the following standards shall occur at all times:
1. There shall be no display which would indicate from the exterior
that the building is being used for any purpose other than a
residential dwelling.
2. There shall be no outside storage of materials visible from public
property or adjacent private property.
3. Mechanical equipment, unless compatible with residential
purposes, shall be prohibited.
4. There shall be no offensive noise, vibration, smoke. dust, odors,
heat or glare noticeable at or beyond the property line resulting
from the home occupation.
5. The home occupation shall not create hazardous traffic conditions
or utilize on -street parking of nearby properties.
6. If the proposed home occupation requires any modification to the
dwelling or accessory structure of a nature that is not typically
found in a residential district, the proposed home occupation is
considered inappropriate and prohibited.
7. No merchandise, other than what is produced on-site shall be sold
to the public from premises.
Homeocaapafim,l.f mll.I.UB
8. The use or storage of heavy equipment or heavy vehicles shall not
be permitted. Heavy equipment and heavy vehicles shall include,
but not be limited to the use of: semi -trucks, trucks and trackers,
back hoes, bob cats, refrigerator trucks, livestock trucks,
commercial buses, farm tractors, garbage trucks and log trucks.
9. Any home occupation, which requires more than 1 vehicle for its
operation shall be prohibited. The 1 vehicle permitted is limited to
passenger vehicles, passenger vans or pick-up trucks.
10. No residence shall be used as a headquarters or dispatch center
where employees or subcontractors report to the residence to be
dispatched elsewhere.
11. Customer access to home occupations is limited to the hours of 7
a.m. to 6 p.m.
12. The applicant shall sign an agreement with the City acknowledging
any applicable standards listed in Subsections 1. through 11.,
above.
D. The following uses are prohibited as a home occupation:
1. Automobile repair, including, but not limited to: tune-ups,
alignments, body -fender work, painting, detailing and upholstering;
2. Health salons, gyms, dance studios, aerobic exercise studios,
karate and judo instruction;
3. Medical and dental offices;
4. Mortician, hearse services;
5. Tow truck services;
6. Veterinary uses (including care, grooming and boarding);
7. Wholesale distribution taking up more than the equivalent of 40
percent of the primary residence;
8. Gun dealerships involving and storage of guns for sale or
customers visiting the residence.
HvmeOccuparionlyro�meriav11.13.O8ddk
E. Any home occupation:
In violation of the provisions of this Code shall be subject to civil
infraction citation process of the Springfield Municipal Code, 1997,
Article 5.15.1. Any proposed home occupation, or component
thereof, not specifically identified in the Springfield Development
Code shall be prohibited unless authorized by the Springfield
Planning Commission as the result of an application for Formal
Interpretation.
2. Which has been approved by the Planning Commission shall be
subject to revocation by the Planning Commission if the home
occupation is found to be in violation of the approval standards. The
revocation shall be sent to the applicant in writing. The home
occupation shall cease within 30 days of the receipt of the
revocation notice. The revocation decision may be appealed to the
City Council as specified in Section 5.3-100.
Acknowledgement of receipt of Home Occupation Information (SDC 4.7-165)
Name Business
L KV,\ f .5 W a VIA Name ekw c e' G iAr
Addres
s 3 85 V, 54Tu SPrLO 02--1-74-79�
Type of Home Occupation
Business
Signatur
Home mpe0oNufolma wl1.13.08d
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