248 LEVY OCEAN WAVES BTR CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
LOCAL BUSINESS TAX APPLICATION
Section 1
APPLICATION TYPE: New Business Transfer of Ownership
Transfer to New Location:Previous Location
BUSINESS NAME: OCEAN WAVES SUNGLASSES LLC
LOCATION ADDRESS: 248-3 LEVY RD. —
MAILING ADDRESS: 248-3 LEVY RD.
BUSINESS PHONE: 904-477-5459 FAX. 904-280-0522 CELL:
EMAIL ADDRESS:CROWNRE@BELLSOUTH.NET
BUSINESS ENTITY IDENTIFICATION NUMBER: Federal Employer I.D.Number 47-3061363
or
Social Security Number -- -----
PLEASE EXPLAIN THE NATURE OF THE BUSINESS:
RETAIL SALE OF SUNGLASSES
SQUARE FOOTAGE OF BUSINESS PREMISES: 1,534
(Include both buildings and outside areas used in conjunction with the business,but not patron parking areas.)
Will the following be served? Food: Yes No
Alcohol: Yes gN
If yes, Select One: ICOP 2COP 4COP
If restaurant,will dogs be allowed? Yes
Will you have any vending machines? Yes (NJo If yes, please provide quantity and type below:
Section 2 TRAVIS WILKERSON
APPLICANT/LOCAL MANAGER/PRINCIPAL OFFICER:
HOME ADDRESS: 1027 REGAS DR. S., ATLANTIC BEACH, FL 32233
HOME PHONE: CELL: 904-477-5459
DATE OF BIRTH: 04/08/1978 DRIVERS LICENSE#:W426938781280 (Please attach a copy.)
EMAIL ADDRESS: TRAVIS@OCEANWAVESSUNGLASSES.COM
STATE LICENSE/CERTIFICATION/REGISTRATION#(if applicable,attach copy):
Section 3
1,the undersigned,swear that the above statements are true and correct and I agree to notify the City Clerk if there is
any change in the above information.
I further understand that issuance of a Local Business Tax Receipt by the City Clerk in no way relieves me of the
responsibility of compliance with all provisions of the Code of Ordinances pertaining to conducting a business in the
City of Atlantic Beach.
:
PRINT NAME
TRAVIS WILKERSON TITLE: MANAGER
SIGNATURE
DATE
No person, firm or corporation shall engage in or manage any trade, business, profession, or occupation in Atlantic Beach
without first obtaining a Local Business Tax Receipt. Application and/or payment does not constitute approval or issuance of
a receipt.