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HomeMy WebLinkAboutZoning Compliance/Use Permit ZONING COMPLIANCE
CERTIFICATE
Planning&Development Services
Building&Code Regulation Division
2300 Virginia Avenue Permit#: 2103-0123
Fort Pierce,FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
Issue Date:
This is to certify that the following discribed property is properly zoned for: NAME CHANGE FROM ANGRY BULL TO LA
NARANJA BAR AND RESTAURANT
Tvoe of Business:
NAME CHANGE FROM ANGRY BULL TO LA NARANJA BAR AND
RESTAURANT
Business Name and Address: LA NARANJA BAR AND RESTAURANT
13490 ORANGE AVENUE, FORT PIERCE FL 34945
Parcel ID No: 2308-601-0060-00014
SIC Code:
COC Required? NO
Alcohol License Type: 2COP --BEER AND WINE FOR SALE-
CONSUMPTION ON PRESMISES OR
SEALED CONTAINERS FOR PACKAGE
SALES
V
Signature
CA �"O'�
Date
PLANNING AND DEVELOPMENT SERVICES
2300 Virginia Ave
Fort Pierce,FL 34982
-— Phone: 772-462-2822—Fag: 772-462-1581
APPLICATION
FORA BUSINESS NAME OR OWNERSHIP CHANGE ONLY
(Not Home Office Use)Permit Number: Date of A Jullication:6
,.SUSINES5`:IIFORIVIATI(?N. ,x -
Name of Business:
New Business Name (if changing): 60f Q
Name of Current Business Owner: U
Name of New Business Owner �� L
Address of Business: !",24-96State: � Zip: `75
Name of Shopping Center, if applicable:
Property Tax ID #for Business Location:
Description of Business: (include a detailed description)
Lec, d h:5,S
Name &Type of Previous Business at this Location:
mn&EM
Attach a copy of the current,active copy of the Business Tax Receipt for the business/property.
:APPLICANT.,MAILING ADDRESS ..,.
Name of Applican�
Address: th State:, Zip:
Phone Number — -3 Email Address: ti Q tjJai i a
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 business/property; 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 aintenance regulations. J
Applicant's Signature: 1 Dater
QFFICE USE ONLY h ,u j x.,,
Required j Yes No " Comments
POD Initials i Business Tax Receipt
Revised: March 2019
CHINS CRAFT
y�'� �� � Servirrgt�urN�g55ocs
s TAX COLLECTOR
2020 20.2 .
S 7. LUCIE COUNTY StAucie County Local Business Tax Receipt
Facilities or machines # Rooms,# Seats #5 Employees # Receipt #1016752
Type of business 5811 REST/TAKE OUT/CONCESSION STAND Expires SEPTEMBER 30, 2021
(RESTAURANT)
DBA name Business ANGRY BULL INC
Mailing address: ANGRY BULL INC Business location: 13490 ORANGE AVE -
13490 ORANGE AVE FORT PIERCE, FL 34945
FORT PIERCE, FL 34945
RENEWAL St Lucie County 266248
Origina[tax: $20.60 P13000027836
Penalty: $5.15
Collection cost: $5.00 Paid 03/04/202,1 30.75 0002-20210304-005265
Total: $30.75
Law requires this Local Business Tax Receipt to be displayed conspicuously at the place of business in such a mannertha.0t can be open to.the
view of the public and subject to inspection by all duly authorized:officers pf the county. Upon failure to do so,the locai'business taxpayer-shall.
be subject to the payment of another Local Business Tax for the same business, profession or occupation.
Pursuant to Florida law, all Local Business Tax Receipts shall be sold by the Tax Collector beginning July 1 of each year and shall expire on
September 30 of the succeeding year.Those Local Business Tax Receipts renewed beginning October 1 shall be delinquent and subject to a
delinquency penalty of 10 percent for the month of October. An additional 5 percent penalty for each month of delinquency is added;until paid,
provided that the total delinquency penalty,shall not exceed 25 percent of the Local Business Tax for the delinquent establishment.
In addition to the penalty,,the Tax Collector is entitled to a collection fee of$1 to$5.This fee is based on the amount of Local Business Tax,
which will be collected from delinquent taxpayers after September 30 of the business year.
This receipt is a Local Business Tax only. It does not permit the local business taxpayer to violate any existing regulatory or zoning laws of the
state, county or city. it also does not exempt the local business taxpayer from any other taxes, licenses or permits that may be required by
law.
Pursuant to Florida law, Local Business Taxes are subject to change.
ANGRY BULL INC
' 13490 ORANGE AVE
FORT PIERCE, FL 34945
.................._
DBPR ABT-6001 —Division of Alcoholic Beverages and Tobacco
Application for New Alcoholic Beverage License
STATE OF FLORIDA DBPR Form
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ABT-6001
Revised 08/2013
If you have any questions or need assistance in completing this application,please contact the Division of
Alcoholic Beverages & Tobacco's (AB&T) local district office. Please submit your completed application
and required fee(s) to your local district office. This application may be submitted by mail, through
appointment, or it can be dropped off. A District Office Address and Contact Information Sheet can be
found on AB&T's web site at the link provided below.
Local ABT District Licensing Offices
`.nt! .t- 4..t
vSECs�fI�Na1 CF ECI LICENSE CAYWN �,� �� � `��< � fi` IW..Y�. ....tt ...tYs..ti z i- -'�.;..kz-u..
License Series Requested Type/Class Requested Do you wish to purchase a Temporary License?
❑ Yes ❑ No
Child License Requested Number of Child Licenses Requested
(Retail Alcoholic Beverages ❑ Alcoholic Beverage Manufacturer
❑ Beer/Wine/Liquor Wholesaler ❑ Passenger Waiting Lounge
Retail Tobaccp Products Dealer Permit (must check one or more of the below)
[:] Pipes Over the Counter ❑ Vending Machine
�' � 'SEC�TION 2LICENSE INFORIVIArrION
„ .� y a.....,+t�` k�?... .»..'9...._. ...:its`_... .....t<_... . �._..... ..�.. _ ..._._.f__ �✓_."'^€ '� _� ���"'Fks�� m r...k
If the applicant is a corporation or other legal entity, enter the name and the document number as registered
with the Florida Department of State Division of Corporations on the line below.
FEIN Number Business Telephone Number E-Mail Address (Optional)
Full Name of Applicant(s): This is the nam the license will be issued in) Department of State Document#
OV
Business Name (D/B/A)
Location Address fStreet and Number)
e e�EW E
City _ County State Zip Code
` E i� ITI_ I I FL
Mailing Address (Street or P.O. Box)
City State Zip Code
,=C,ontaell mrsd isaection is.o tional see a l,catwn;:insil�ructions=for defa�ls t, , � T „.,.
Contact Person Telephone Number
ext. _
E-Mail Address (Optional)
Mailing Address (Street or P.O. Box)
City State Zip Code
ABT District Office Received Date Stamp
Auth.61A-5.010&61 A-5.056,FAC 1
' �This�sect�ont!m�'ust�be�comp`�efeFd4for�each�p�erson 1i e���ly co�"nn"s`ec�'t'"de �niith�F�� ..b�w9n�"� i�ess�R��1ey
1'. Business Name (D/B/A)
2. Full Name of Individual
Social Securitt Number*, Home Telephone Number Date of Birth
Race - h�e-x Height Wei s�t Eye Color Hair Color
Nil C� c � - ' k
3. Are ou a U.S. citizen?
[ Yes ❑ No
If no, immigration card number or passport number:
4. Home Address (Street and Number) _
� . � VC
City State Zip Coed )q
5. Do you currently own or have an interest in any business selling alcoholic beverages, wholesale
cigarette or tobacco products, or a bottle club?
[] Yes M"'No
If yes, provide the information requested below. The location address should include the city and state.
Business Name (D/B/A) License Number
Location Address
6. Have you had any type of alcoholic beverage, or bottle club license, or cigarette, or tobacco permit
refused, revo ed or suspended arywhere in the past 15 years?
❑ Yes &No
If yes, provide the information requested below. The location address should include the city and state.
Business Name (D/B/A) Date
Location Address
7. Have you been convicted of a felony within the past 15 years? ❑Yes o
If yes, provide the information requested below and provide a Copy of the Arrest Disposition, as
requested in the Application Requirements checklist.
Date Location
Type of Offense
8. Have you been convicted of an offensevolving alcoholic beverages or tobacco products anywhere
within the past 5 years? [:] Yes [Q' o
If yes, provide the information requested below and provide a Copy of the Arrest Disposition, as
requested in the Application Re uirements checklist.
Date Location
Type of Offense
Auth.61 A-5.010&61 A-5.056,FAC 2
9. Have you been arrested or issued a n tice to appear in any state of the United States or its territories
within the past 15 years? ❑ Yes VM No
If yes, provide the information requested below and a Copy of the Arrest Disposition.
Attach additional sheet if necessary.
Date Location
Type of Offense
10. Do you meet the standards of the moral character rule?
ff Yes ❑ No
11. Are you an officer or employee of the Division of Alcoholic Beverages and Tobacco; are you a sheriff or
other state, county, or municipal officer, including reserve or auxiliary officers, certified by the state as
such, with a est powers, whose certification is current and active?
El Yes LNo
!KV: T �`:; F4 s� r NOTA�IZATIOIV STAT�IIIIENT f T f z
?r..,-. ,4_�,,.K,..... -- __�."l.,.r:"r.? ...:.� !� .m- .a.w..cn/} .h...?S..E;_s.21. _:N .r.�'k.S;a�; ,ri.i..s..-�`$,".x'�.G_: _ R. :L �,... .:_ .._Y.A.:S:�l,
"I swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45 and
837.06, Florida Statutes, that I have fully disclosed any and all parties financially and or contractually
interested in this business and that the parties are disclosed in the Disclosure of Interested Parties of this
application. I further swear or affirm that the foregoing information is true and correct."
STATE OF ��"�J•�
COUNTY OF OU�3 /
APPLICA IGNATURE
The foregoing was ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this _ Day
ofY�recS , 20Z-k , By �S o�a �� :a %-� -C� who is ( ) personally
(print name of person making ement)
known to me OR ( )who produced as identification.
-- Commission Expires: 3 ZoZ2.
Notary Public
AMA DA701�1
-w" � •k_
My COMMISSION#GG 224359
(ATTACH ADDITIONAL COPIES AS NECESSARY) rj' �:e- EXPIRMAup 3,2022 ids
3unded 7hru Dicta Public J �£_ rderr:riiers
*Social Security Number
Under the Federal Privacy Act, disclosure of Social Security numbers is voluntary unless a Federal
statute specifically requires it or allows states to collect the number. In this instance, disclosure of social
security numbers is mandatory pursuant to Title 42 United States Code, Sections 653 and 654; and
sections 409.2577, 409.2598, and 559.79, Florida Statutes. Social Security numbers are used to allow
efficient screening of applicants and licensees by a Title IV-D child support agency to assure compliance
with child support obligations. Social Security numbers must also be recorded on all professional and .
occupational license applications and are used for licensee identification pursuant to the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (Welfare Reform Act), 104 Pub.L.193,
Sec. 317. The State of Florida is authorized to collect the social security number of licensees pursuant to
the Social Security Act, 42 U.S.C. 405(c)(2)(C)(1). This information is used to identify licensees for tax
administration purposes. This information is used to identify,licensees for tax administration purposes,
and the division will redact the information from any public records request.
Auth.61 A-5.010&61 A-5.056,FAC 3
EC'F O)r4DESC Pl �H ;P Mw
! S T.O` r NEE©
'k � rultOIIIPL . E �`PPWN
Business Name (D/B/A)
li 1. Yes ❑ No Is the proposed premises movable or able to be moved?
2. Yes ❑ No p/ Is there any access through the premises to any area over which you do not have
dominion and control?
3. Yes ❑ No Q/ Is the business located within a Specialty Center? If yes, check the applicable statute:
❑ 561.20 2 b 1, F.S. or❑ 561.20 2 b 2, F.S.
4. Yes ❑ No Are there any mobile vehicles used.to sell or serve alcoholic beverages?
5. Yes ❑ No p,/ Are there more than 3 separate rooms or enclosures with permanent bars or
counters?
Neatly draw a floor plan of the premises in ink, including sidewalks and other outside areas which are contiguous to the
premises,walls,doors,counters,sales areas,storage areas, restrooms, bar locations and any other specific areas which-
are part of the premises sought to be licensed. A multi-story building where the entire building is to be licensed must
show the details of each floor.
Auth.61 A-5.010&61 A-5.056,FAC 4
FBusiness
Ar
F li.f Applicant: (�Ut e name the liclnse will be issued in)
me.(D/B/A)
N 3K.(1 +a QJ
Street Address} �qo
� � eawn )�r County State ip ode
t%3NIR
MEn B._= =:OML : _.:D BYT1E. -9_I G T' SINE '. A�fIQN
A. The location complies with zoning requirements for the sale of alcoholic beverages or wholesale
tobacco products pursuant to this application for a Series: nL Type:�)license.
B. This approval includes outside areas which are contiguous to the premises which are to be part of the
premises sought to be licensed and are identified on the sketch?" ❑ Yes ❑ No
Check either: Please do not skip,this is important for license fee sharing
❑ Location is Within the city limits or ~ oc/ation�is in the unincorporated county
Signed V W � �-�✓ Date 5 4/G�j
Title �' /Ltxl 2��lLrt� t/ZS�`I`his approval is valid for days.
' J 1
411
FThis
Q4« t 3 Y L ry5 hd 4i3 3Al.3 � , SALESTA�Cn� q� � � a � � �� � �� hxIn
,, _t __applicant for a license/permit has complied with the Florida Statutes concerning registration for
se Tax.
verify that the current owner as named in this application has filed all returns and that all
outstanding billings and returns appear to have been paid through the period ending
or the liability has been acknowledged and agreed to be paid by the applicant. This verification does not
constitute a certificate as contained in Section 213.758 (4), F.S. (Not applicable if no transfer involved).
2. Furthermore, the named applicant for an Alcoholic Beverage License has complied with Florida Statutes
concerning registration for Sales and Use Tax, and has paid any applicable taxes due.
Signed Date
Title Department of Revenue Stamp
This approval is valid for days.
--4K
t TO BE'COMP,L�ETED BYfTHEDIVISlONOF HOTELS AND RESTAURANTS (
,' i K r2#'
ORCOUNTY'44M HA-"- RITY�
The above establishment complies with the requirements of the Florida Sanitary Code.
Signed Date
Title Agency
This approval is valid for days.
Auth.61A-5.010&61A-5.056,FAC 5
;? , CTtO Pl=�C �s�a' N Mly
Business Name (D/B/A) -
1 ,4 1
Has the applicant entity been convicted of a�fg ony in this state, any other state, or by the United States in
the last 15 years?
❑ Yes 91V0
If the answer is "Yes," please list all details including the date of conviction, the crime for which the entity
was convicted, and the city, county, state and court where the conviction took place.
(Attach additional sheets if necessary)
{b U-11 UNNAw SPECIAI NLfCE SExR QUIREMENT , > f i
,p1 "OffeEERVAND'1lVlNE LICENSES t�F ���' :� 4,7�f
Please check the appropriate box of the license for which you are applying. Fill in the corresponding
requirements for the license type sought.
❑ Quota Alcoholic Beverage License ❑ Specialty Alcoholic Beverage License (e.g. SRX, S, etc)
❑ Club Alcoholic Beverage License
This license is issued pursuant to , Florida Statutes or Special Act, and as such we
acknowledge the following requirements must be met and maintained:
Please initial and date:
Applicant's Initials Date
Auth.61A-5.010&61A-5.056,FAC 6
Note: Failure to disclose an interest, direct or indirect, could result in denial, suspension and/or revocation of your license.
You MUST list all persons.and entities in the entire ownership structure. To determine which of those persons
must submit fingerprints and a Related Party Personal Information,sheet,,see the fingerprint section in the
application instructions.
Business Name (D/B/A)
1. When applicable, complete the appropriate section below. Attach extra sheets if necessary.
Title/Position Name Stock%
CORPORATION-List all officers,directors,and stockholders
GENERAL PARTNERSHIP—List all general partners
LIMITED LIABILITY COMPANY-List all managers(member&non-member),directors, officers, and members
LIMITED PARTNERSHIP-List all general and limited partners.
LIMITED LIABILITY PARTNERSHIP-List all partners
Bar Manager(Fraternal Organizations of National Scope only):
OTHERINTERESTS
These questions must be answered about this business for every person or entity listed as the applicant
1. Are there any persons or entities not disclosed who have loaned money to the business? ❑ Yes [5 No
2. Are there any persons or entities not disclosed that derive'revenue from the license solely
through a contractual relationship with the licensee,the substance of which is not related to the ❑ Yes [5 No
control of the sale of alcoholic beverages, or is exempt by statute or rule?
3. Are there any persons or entities not disclosed that have the right to receive revenue based on ❑ Yes [''No
a contractual relationship related to the control of the sale of alcoholic beverages?
4. Are there any persons or entities not disclosed who have a right to a percentage payment from ❑ Yes ff No
the proceeds of the business pursuant to the-lease?
5. Are there any persons or entities not disclosed who have guaranteed the lease or loan? ❑ Yes a No
6. Are there any persons or entities not disclosed who have co-signed the lease or loan? ❑ Yes [ No
7. Is there a management contract,franchise agreement, or concession agreement in connection ❑ Yes ["No
with this business?
8. Have you or anyone listed on this application, accepted money, equipment or anything of
value in connection with this business from any industry member as described in 61A-1.010, ❑ Yes [O No
Florida Administrative Code?
If you answered yes to any of the above questions, a copy of the agreement must be submitted with this
application. The terms of the agreement may require the interested persons or parties related to an entity to
submit fingerprints and a related party personal information sheet.
Auth.61 A-5.010&61 A-5.056,FAC 7
E.?0`1 ATOIillR�
Business Name (D/B/A)
"I, the undersigned individually, or on behalf of a legal entity, hereby swear or affirm that I am duly authorized to
make the above and foregoing application and, as such, I hereby swear'or affirm that the attached sketch is a
true and correct representation of the entire area and premises to be licensed and agree that the place of
business, if licensed, may be inspected and searched during business hours or at any time business is being
conducted on the premises without a search warrant by officers of the Division of Alcoholic Beverages and
Tobacco, the Sheriff, his Deputies, and Police Officers for the purposes of determining compliance with the
beverage and retail tobacco laws."
"I swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45 and
837.06, Florida Statutes, that the foregoing information is true and-that no other person or entity except as
indicated herein has an interest in the alcoholic beverage license and/or tobacco permit, and all of the above
listed persons or entities meet the qualifications necessary to hold an interest in the alcoholic beverage license
and/or tobacco permit."
STATE'OF
COUNTY OF
PcOID/01
T
APPLICANT/AUTHORIZE REPRESENTATIVE NAME
APPLICAN THORI REPRESENTATIVE SIGNATURE
The foregoingwas ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this 1 Day
of `�°�� , 20_� , By ��5� �� �� ���¢ � • who is ( ) personally
(print name(s) of person(s) maki statement)
known to me OR ( ) who produced �����i�. as identification.
4
Commission Expires: "
Notary Public
ANA?i i41CIADIAZ-��
c�-VtWlsslcrl*GG 224851
horded'hm^t�fary Public UnderP�nt m
Auth.61A-5.010&61A-5.056,FAC 8
This section is to be completed for all current alcoholic beverage and/or tobacco license holders listed on the
application to ensure the most up to date information is captured.
Business Name (D/B/A)
Last Name First M.I.
Current Alcohol Beverage and/or Tobacco License Permit/Number(s)
Date of Birth Social Security Number*
Street Address
City State Zip Code
Last Name First M.I.
Current Alcohol Beverage and/or Tobacco License Permit/Number(s)
Date of Birth Social Security Number*
Street Address
City State Zip Code
i
Last Name First M.I.
Current Alcohol Beverage and/or Tobacco License Permit/Number(s)
Date of Birth Social Security Number*
Street Address
City State Zip Code
Last Name First M.I.
Current Alcohol Beverage and/or Tobacco License Permit/Number(s)
Date of Birth Social Security Number*
Street Address
City State Zip Code
Last Name First M.1.
Current Alcohol Beverage and/or Tobacco License Permit/Number(s)
Date of Birth Social Security Number*
Street Address
City State Zip Code
Auth.61 A-5.010&61 A-5.056,FAC 9