HomeMy WebLinkAboutApplication APPLICANT 1/13/2022City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELDIL
(City Staff completes form)
Permit Type
Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: ❑
City:
Dept of Motor Vehicles -Renewal: ® Zoning Verification Letter: ❑ UGB: ❑
Project Information
Applicant: Vincent Garza Phone: 541-514-8115
Company: Royalty Automotive Email:
Address: 406 South 35" St., Springfield, OR 97478
Property Owner:
Phone:
Company:
Cell:
Address:
ASSESSOR'S MAP NO: 17-02-31-31
TAX LOT NO(S): 6600
Property Address: 3477 Main Street, Springfield, OR 97478
Description of Proposal:
DMV change of ownership / co -locate
Record Information
Record No: 811-22-000024-TYP1
Date Received:1/13/2022
Application Fee: $348.00
Technical Fee: $17.40
TOTAL FEES: $365.40 Assigned Planner: Drew Larson
Revised 11.2.11 k1
10
APPLICATION TO CORRECT DEALER / REBUILDER
VEHICLE DEALER CERTIFICATE
w...E.�....a.m..,,,. DEALER NUMBER
DLO935
EFFECTIVE DATE
e"Fi1TRIN DATE
CURRENT BUSINESS NAME
Royalty Automotive
Check the reason for correction:
❑ Name Change ®Address Change ❑ Add / Remove Owners ❑ Org. / Structure Change
Instructions: VALIDATION USE ONLY
• The fee fora co racted conificate: $30.
• Name change and/or address change: $30. Attach Bond trailer and Insurance Cerlficals.
• Organizational SWcture change: $30. (e.g., In ividual rannership or LLC to Cory)Allach a bond rider
and insurance certificate.
• Adding/Removing LLC member or corporate at No Fee
• Each new owner must complete and sign lines 12-16 or 17-21.
• Each owner being removed must Sign line 22 or 23.
• One Owner must sign line 24.
• Provide copy of valid photo ID if changing residence address.
• Dealer number and expiration date will stay the same.
Submit the completed application to: DMV Business Licensing, 1905 Lana Ave NE, Salem Oregon 97314.
NOTE: If the dealership has been sold, the new owners) must obtain their own vehicle dealer certificate using the Form 735370 Packet since a dealer
conificale is not transferable.
NAMECHANGE
New BUSINESS SAME(tlessumeE Lunn in, s! in R,iS, Nuni af) JORESONBUSINESS REGISTRY Su..EB
FEDER/LLEMPLOYERIDENT ICPTION NUMBE
Any alteration of Line 3 voids location approval.
ADDRESS CHANGE
ER &11N O DRESIOENCE EIFREVIOUSSUPY.EMOWA
BUSINESSTELEPoIONE
3477 Main St
(541 ) 514-8115
E
Springfield
97478
Lane
C
406 South 35th
Springfield
97478
roymotivel@gmail.com
zl
406 South 35th st
Springfield
97478
PREVIOUS STRFP7rAxoEESS OF BUSINESS LOCATION
IP E
4106 Main St
Springfield
97478
LOCATION APPROVAL - Required only if dealer is changing business location
Certification of Local Zoning and Business Regulatory Compliance. 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)j Displays a new or used vehicle, trailer or semiheiler; 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 jurisdiction allows the applicant ANY of the activities in (a) through (c) above under its ordinances, at the location of
the business given on Line 3.
As thezoning official forte jurisdiction where this business is lomted, l verify by my signature balm that ineocation ofthis business assown on this application
complies with any land use Ordinances m business regulatory ordinances of the jurisdiction pursuant to ORS 822.025(6).
yCITY OF: Q COUNTY OF- TELEPHONE NUMBER
J r.n «l� (544 )116 101
PRINT NAME
v-
1
TITLE
I TFC,
Al4A. r
sIGNATURE, ^ /
DAT
X7V/(//L�
nA. 63 �LZ
Place stamp or seal here V
Restrictions on the location
approval are in an attached
letter from the zoning authority.
APPR011ED
CITY OF SPRINGFlRD