HomeMy WebLinkAboutMiscellaneous Application 1990-5-31
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SUPPLEMENTAL DEALER/REBUILDER BUSINE.ERTIFICATE
APPLICATION
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CERTIFICATE NO:
NOTES: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE DELAY
PLEASE TYPE OR PRINT LEGIBLY WITH INK
ALL SUPPLEMENTAL LOCATIONS MUST OPERATE UNDER THE SAME
OWNERSHIP AND BUSINESS NAME AS SHOWN ON THE CURRENT
CERTIFICATE
(0").
~
BUSINESS TELEPHONE
74 )-7682
~
I NAME (CORPORATION ANDIOR ASSUMED BUSINESS NAME)
1 Staff Jennings, Inc.
., I SUij'!J-1tl'EW.t~ ~~~efREET AND N~MBER)
, I-MAILlloiG ADDRESS
3 P.O. Box 16
MAIN BUSINESS LOCATION
8240 S.W. Macadam
CITY
Spri ngfi,e 1 d
CITY
Spri ngfield
Portland, Oregon 97219
ZIP CODE
9747-'-,
COUNTY..
,u ,. ~Lane
I ZIP CODE
97477
STATE
Oregon
4
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.
51 NAME I TITLE I (ESID)NCE TELEPHONE
61 ADDRESS,CITY,STATE,ZIPCODE I ~GNATURE
I CERTIFY THAT SURETY BOND NO, LfiJlL"ln,14!1ns:lB.!l9
WILL COVER THE BUSINESS OPERATION AS SUPPLEMENTED ABOVE,
Jnited States Fidelity and Guaranty Compar
tfjPLACE SURETY SEAL HERE)
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SIGNAT~RE OF SURETY/REPRESENTATIVE
G.M,Burnett, Attorney-in-fact
TITLE DATii_1_ qn
~
APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES 10
WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OF THE
7 0 CITY 0 COUNTY OF
II CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPUCATION AND AS I
EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE SEAL OR STAMP OF
THE CITY OR COUNTY,
TITLE ~ 11
vi.l..),~
OATe 12
;;/?,An
NAME
8 r""DlVl'..o~;>~ M=I'T
SIGNATURE ^
9 ~ "'~
() () &CESTAMPOR'SEALHERE)
I APPROVED
CITY OF SPRINGFIELD
F~
SUBMIT APPLICATION WITH ALL REOUIRED SIGNATURES AND FEES TO:
BUSINESS LICENSING UNIT
1905 LANA AVE. NE
SALEM OR 97314-2350
735-372 (lHl7)
p
OREGON - T ~
MOTOR
VEHICLES ~ li
DIVISION
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SUPPLEMENTAL DEALER/REBUILDER BUSINESS CERTIFICATE
APPLICATION
CERTIFICATE NO:
NOTES: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE DELAY
PLEASE TYPE OR PRINT LEGIBLY WITH INK
ALL SUPPLEMENTAL LOCATIONS MUST OPERATE UNDER THE SAME
OWNERSHIP AND BUSINESS NAME AS SHOWN ON THE CURRENT
CERTIFICATE
NAME (CORPORATION AND/OR ASSUMED BUSINESS NAME)
BUSINESS TELEPHONE
1
2
) MAILING ADDRESS
3 P,O. BOX 16,
MAIN BUSINESS LOCATION
qAFF ..1FNNHlr;~, IHr
SUPPLEMENTAL LOCATION (STREET AND NUMBER)
4675 MAIN STREET
CITY
S PR I NG FI ELD
SPRINGFIELD
ZIP CODE
97477
STATE
OREGON,
7g,fJ- 7.hP.?
COUNTY
LANE
\ ZIP CODE
97477 '
CITY
4 ~40 S,W, MACADAM. PORTLAND. ORFr,ON 97?lq
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.
I NAME
5 JEFFREY S, JENNINGS
I ADDRESS, CITY, STATE, ZIP CODE
6 ~924 S,W, RIVERRIDGE LANE PORT, OR 97?01
APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES
WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OF THE
D CITY [XJ COUNTY OF
I TITLE
PRESIDENT
10
I RESIDENCE TELEPHONE
!1 , (J /I (503 228-5948
I ~GNAr~l~
ICERTlFYTHA~~~ERvBOrDNO' 7!tnl1n1 ~1lf1P.P.4q
WILL COVER T E1!t/J~ESS PERATiON!AS SUPPLEMENTED ABOVE,
Unit d State Fidelity and Guaranty
~ C;Jmpany
PLACE SURETY SEAL HERE)
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t< .~..
, /?4r:/fr /ddUz;/
SIGNATUREOFSURETY/R~PRESENTATIVE G t1 Burnett
~ttorney-in-fact 1-~1-89
TITLE DATE
7
Lane
II CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS
EVIDENCE OF SUCH AUTHORITY 00 AFFIX HEREON THE SEAL OR STAMP OF
THE CITY OR COUNTY,
I NAME TITLE
8 ~ .-.,., fJLOII \.>~. <:o'ot1v~.N
91 ~~0~RSF" WCDC' ~/I~8'1
APPROVED I
CITY OF SPRINGFIELD
I
111
112
FEE: $3000
SUBMIT APPLICATION WITH ALL REQUIRED SIGNATURES AND FEES TO:
BUSINESS LICENSING UNIT
1905LANAAVE,NE
SALEM OR 97314.2350
A<>7"'~
OREGON ~ T ~
MOTOR
VEH'CLES ~ il
DIVISION
-
-
-.
,SUPPLA-rAL DEALER/REBUILDER BU~INESS "IFIC~TE
APPLICATION
-..----. -. .._- _.-.
I
CERTIFICATE NO:
1290
NOTES: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE DELAY
PLEASE TYPE OR PRINT LEGIBLY WITH INK
ALL SUPPLEMENTAL LOCATIONS MUST OPERATE UNDER THE SAME
OWNERSHIP AND BUSINESS NAME AS SHOWN ON THE CURRENT
CERTIFICATE
,NAME (CORPORATION AND/OR ASSUMED BUSINESS NAME)
1 Staff "ennings, Inc
I SUPPLEMENTAL LOCATION (STREET AND NUMBER)
2 4675 Main St.
I MAILING ADDRESS
3 POBox 16
I MAIN BUSINESS LOCATION
4 8240 S~ W. Macadam Ave. Portland, OR 97219
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.
I NAME
5 Jeffrey S. Jennings
I A~;ESS, CITY, STATE, ZIP CODE
6 2h s, W, Riverid2B Wav Portland, OR 97201
APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES
WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OFTHE
CITY
Springfield
CITY
Springfield
ZIP CODE
97477
BUSINESS TELEPHONE
746-7682
COUNTY
Lane
ZIP CODE "
97477
STATE
OR
I TITLE
Pres.
/1 I, I /1 · r~~~)~~~~E5~:~NE
I ~GNt7:r1e(ji U/lVlivyt((J
10
I CERTIFY r1A:bfuRrjrv B'!.~D NO. I
WILL COVE7 TV~ BU;INES10PERAT~ON AS SUPPLEMENTED ABOVE.
. t I . .
7
o CITY
o COUNTY OF Lane
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,
NAME TITLE
8 ~~, '-lQ.*-- "r.I.l.~ ~ AOM".,
SIGN~TURE DATE
9 x0" \f\ ~V[~k7
, OLA~ESTAMPORSEALHERE)
APPROVED
em' OF SPRINGFIELD
(PLACE SURETY SEAL HERE)
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11
12
SIGNATURE OF SURETY /REPRESENTATIVE
, - --:,:: ~-:";- ......... . -
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- 'r
TITLE
DATE
FEE: $3000
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SUBMIT APPLICATION WITH ALL REQUIRED SIGNATURES AND FEES TO:
. " BUSINESS LICENSING.UNIT'
, " 1905LANAAVE:NE."
SALEM OR 97314-2350 '
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735-372 (9-87)
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