HomeMy WebLinkAboutAPPLICATION FOR A BUSINESS NAME OR OWNERSHIP CHANGE PLANNING AND DEVELOPMENT SERVICES
® 2300 Virginia Ave
e Fort Pierce,FL 34982
Phone: 772-462-2822—Fag: 772-462-1581
APPLICATION
FOR A BUSINESS NAME OR OWNERSHIP CHANGE ONL Y
(Not Home Office Use)
Permit Number Date of A lication:
Name of Business:
New Business Name(if changing): REBEL#820
Name of Current Business Owner: SPEEDWAY LLC.
Name of New Business Owner FUTURE ENERGY FLORIDA INC.
Address of Business: 6601 South US Highway 1 PORT ST. LUCIE State: FI, Zip: 34982
Name of Shopping Center, if applicable: N/A
Property Tax ID#for Business Location: 3415-501-0037-010-2
Description of Business: (include a detailed description) GAS STATION WITH PACKAGE SALES OF BEE
AND WINE.
Name &Type of Previous Business at this Location: SAME.
Attach a copy of the current, active copy of the Business Tax Receipt for the business/property.
Name of Applicant: AN UEISHA JONES
Address: 2525 PONCE DE LEON BLVD, STE 1080 CORAL GABL_ESState: FL Zip: -31134
Phone Number: 305-809-8124 Email Address: AN UEISHA. ONES@SPIRITUSLAW.COM
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. 1 further understand that a site inspection may be required to ensure compliance with applicable land
development,building safety,an props, maintenance regu 7,..
Applicant`s Signature- ,L� Vie_ Date: /
y' .' ^.t{ie� Tk:'r34 ''��
{#� & ( Required _ Yes Nv Comments
POD Initials i Business Tax Receipt
Revised:March 2019