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APPLICATION FOR BUSINESS NAME OR OWNERSHIP CHANGE ONLY
it P AKA DEV LO; 3ERXJ CF.S 3atlYfrgNaAve`_, • . FdrtPletee�FL 3446� ,_ 1Pho ?7I-AG24W ftwl i�iS81 Ap ATIQN. `�.4 B11�S1NF,.S�IVAME©RQW1V�QS�/P�,�{Y �Q ` PNnmber. I.,o Norris ofi business:r JSA CAPITAL LLC DBA.BC,,Motars Port St,;Lucas Name of ;business Owner: ADAM RAFAEL Norte of 13tssmess pwnec Address of Bt stness' 720'[ S US HWY, Port`-'Sainflucie Shait� EC, 34952: Name of Shopping Center,?�f appticable> , � � z Property Tax>1>�#rfoc Business'Locatior 37-'I 3490'83 OF AUTCY;SALES` US1=D G�ARS/TRUCKS De�criptionof8trs�ness�._{tncii��easieta�eddescripttan} .. _-.. .. . - .... Nam ou's Bu EMMONSAU.D BROpePie&Ty re satsston KERS;INC.DBA CEt EBR11Y . ,' ' _ _ ,, Aftach a copyafi'liie`'curt'eti�.active copyofthe:Bttsiness�'ei�Recelptfertite�busiriess/property;: `' ' APPr FAEL. Name;ofA fcanh AC?AMRA ,Q►dtlress:. 7201 S US HIIUY I=PORT.SAINT.LUCIE State. xip952 .x t , _ i P"hane.Number., 772 242 5039 Emait{�ddres .;dtorres:@bcrrtotorspsl.ccim This app cation is ogiy to update an owner name ar bus[nesa name. `To—for t-t appiication,there must 6e an ate@ businesst�ctecetptfortttehasit<esalproperty,aoci�awofuse(than}learmodifis�onafthecharacter,typoor nbensffyofair j >existing u or the lncluslon of sdtlltioaat assay may fre-proposed,and se nQ RNA- 'pa(fte[atton,conswlon,�t�eccnstntctton ar :any POP-devetopmeat imroiving a hutldtng,sttuctur± .paved parking area,drhreway cotmscgon,or imt upon a protectet! `patural habitat;t further understand that a site inspection antay 6e rp".es!'to-ensun,coiepf ftce vri(it,appfieabte>[atid. de`veiapmettt,hutidieg saieiy,,u P �FY attoereguiattons. . App6tttt'&S.Ig,tBttlCB• Dste< r t QFFICB.USE tY Required o, Comments POD;In ats; ness'TaxReceiO "