HomeMy WebLinkAboutZoning Compliance Home Use PLANNING AND DEVELOPMENT SERVICES
2300 Virginia Ave
Fort Pierce,FL 34982
Phone: 772-462-2822—Fax: 772-462-1581
_ APPLICATION
i FORA BUSINESS NAME OR OWNERSHIP CHANGE ONLY
(Not Home Office Use)
Permit Number: Date of Application:
BUSINESS INFORMATION_
Name of Business: fY)Fg (?0f1NT ITSCOUNT FO ob ONb 3EvfzRa6fFLLC
New Business Name (if changing):
Name of Current Business Owner: o?Z N) Fo U T A T N C .
Name of New Business Owner 'IyPoc k 'J) /Y ffT
Address of.Business: (,1,�p , 5 US N jQ H W State: F(,— Zip: 3 $L.
Name of Shopping Center, if applicable:
Property Tax ID#for Business Location: 3 Lf O 66 —OO,g 3p p p
Description of Business: (include a detailed description) 6"1 o 5To R_e
Name &Type of Previous Business at this Location: S A E . Q V Qr/V E SS
m E Rc O A N _WS COUNT Hob 19(Qs Q FvE r96 Q L.L'C
Attachcagcopypf:the current, active copy of the Business Tax Receipt for the business/property.
_APPLICANT MAILING-ADDRESS, ,
Name of Applicant �1 POG'(< 17 /v�- K .
Address: CO I,SO , S VS N�Q}I WO-j I State: FL— Zip: 3LJIS2—
Phone Number: 54 — ,%g — !IS S' . Email Address: Sh 0 pO 11 6 zo00 . CO M .
This application is only to update an owner name or business name. To qualify for this application, there must be an active
business tax receipt for the businessiproperty;no change of use(change or modification of the character,type or intensity of an
existing use or the inclusion of additional uses) may be proposed; and no erection, alteration, construction, reconstruction or
any type of development involving a building, structure, paved parking area, driveway connection, or impact upon a protected
natural habitat. I further understand that a site inspection may be required to ensure compliance with applicable land
development;building safety,and property maintenance regulations.
Applicant's Signature: _DJ'P64/c __b Qy.R MIA - Date: O 4
OFFICE'USE ONLY:
Required Yes No Comments
POD Initials I Business Tax Receipt
Revised: March 2019