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Temp. Use Permit - United Pentacostal ChurchCity of Okeechobee 55 SE Third Avenue Okeechobee, FL 34974 (863) 763 -3372 Temporary Use Permit Permit Number: 16 -002 Permit Expiration: February 12, 2016 11:59PM Purpose of Request: Barbeque Fundraiser Property Owner: Karla Roby & Debra Sales Address: P.O. Box 1395 City: Okeechobee State: Florida Zip Code:34974 Date(s) of Event: February 12, 2016 8AM -5PM Applicant: United Pentecostal Church Applicant's Address: 13333 NE 7th Terrace 34972 Phone Number: 863 - 801 -4042 Address of Project: 1600 S Parrott Avenue Current Zoning: Heavy Commercial (CHV FLU Designation: Commercial (C) Subdivision: 1st Addition to South Okeechobee Restrictions /Remarks: All debris must be removed upon final completion date. Owner understands and agrees to the following: X Issuance of a permit may be subject to other conditions and time limitations. X Issuance of a permit is not authorization to violate public or private restrictions. X Failure to comply with applicable regulations may result in withholding future permits. X There may be additional permits required from other governmental entities. Applicant's na ure eneral Services Assistant REF: .ORD.716, Temporary Structures February 9, 2016 Date CITY OF OKEECHOBEE General Services Department, Room 101 55 Southeast 3rd Avenue Okeechobee, FL 34974 Phone: 863 - 763 -3372 ext. 218 Fax: 863 - 763 -1686 DATE RECEIVED: /(, DATE ISSUED: APPLICATION No: 11. -00D- DATES) OF EVENT: Fe 1 r loci co FEE: $175.00 DATE PAID: If Non - Profit/Civic Organization /\/ / " TEMPORARY USE PERMIT APPLICATION OTHER TEMPORARY STRUCTURES (SEC 666 APPLICANT I Name of Property Owner(s): \ lJ \ -_ Sa 5 /T Legal Description of Property: 16•-j ADD, �(t V/'1 T o ut_1 tom V% k t c �P, j t— Address: 0 1J o) ISQ` 0 ei . F i 3 q 6 73 Please Explain Type of Use: Fcknd rc-1 i' `s en Telephone Numbers: Home: Work: North:gn r East: /4.L o �� L Mobile /Cell: (.04 31 ager: Other temporary structures subject to the fo Ilowing regulations: 1. Christm as tree, fireworks and similar seasonal sales operated by a non - profit organization. 2. Carnival, circus, fair or other special event operated by a non - profit organization on or abutting their principal use. * 3. Com mercial carnival, circus or fair in commercial or industrial districts. 4. Similar temporary structures where the period of use will not exceed 30 days a year. The applicant shall: 1. Submit proof of liability insurance, paid in full covering the period for which the permit is issued, in the minimum amount of $1,000,000.00 per occurrence. 2. Remove all debris within 48 hours of expiration of permit 3. Have notarized written permission of property owner, if applicant is not the property owner. 4. Submit Site Plan * 5. Submit State Inspection Certificate(s) * 6. Submit State Annual Permit * Nam a of Applicant: (64k11.3--pp Address: N 7n► '�� A, a 6, 3 y q- -. b n in ,`J . 1- C D F"L Telephone Numbers: Home: Work: Mobile /Celle -1_ Pager: Date: PROPERTY I Future Land Use Map Designation: C Current Zoning Designation: (1 /.{ ij/ Legal Description of Property: 16•-j ADD, �(t V/'1 T o ut_1 tom V% k t c �P, j t— Address of Property: I t ®O S . ?car r� Ate_ Please Explain Type of Use: Fcknd rc-1 i' `s en Briefly describe use of adjoining property: 'j North:gn r East: /4.L o �� L South: -Dam_ t f\I GI S West: / J (; ^..l l_.-OA , Z or Other temporary structures subject to the fo Ilowing regulations: 1. Christm as tree, fireworks and similar seasonal sales operated by a non - profit organization. 2. Carnival, circus, fair or other special event operated by a non - profit organization on or abutting their principal use. * 3. Com mercial carnival, circus or fair in commercial or industrial districts. 4. Similar temporary structures where the period of use will not exceed 30 days a year. The applicant shall: 1. Submit proof of liability insurance, paid in full covering the period for which the permit is issued, in the minimum amount of $1,000,000.00 per occurrence. 2. Remove all debris within 48 hours of expiration of permit 3. Have notarized written permission of property owner, if applicant is not the property owner. 4. Submit Site Plan * 5. Submit State Inspection Certificate(s) * 6. Submit State Annual Permit * hereby certify that the information on this application is correct. The information included in this application is for use by the City of Okeechobee in processing my request. False or misleading inform ation may be punishable by a fine of up to $500.00 and imprisonme t of u to ,hir day and may result in the summary denial of this application. Signature of Applicant ff (Please review the application, attach comments or special conditions): Date Occupational and /or State License Verification: ,,K 01 bovia(2_, Date: Shi( !' Fire Department Approval: Date: 09 FIN, a2OI4 Police Department Approval: Dated ,F., /,,,� Public Works Department Approv Date: Building InspectorApp'.val: y / �— _ _ Date City Ad min istrat or Approval. i � Date: , /s Revised 2/1/08 bjc DSearchResults Okeechobee County Property Appraiser updated: 2/4/2016 Parcel: 3-28-37-35-0050-00290-0010 « Next Lower Parcel : Next Higher Parcel» Owner's Name ROBY KARLA H & SALES DEBRA S Site Address 1600 S PARROTT AVE, OKEECHOBEE Mailing 1906 SW 5TH AVE Address OKEECHOBEE, FL 34974 Description p 1ST ADDITION TO SOUTH OKEECHOBEE LOTS 1 TO 12 INC & ALLEY BLOCK 29 NOTE: This description is not to be used as the Legal Description for this parcel in any legal transaction. Land Area 2.066 ACRES S/T /R 28 -37 -35 Neighborhood 518610.00 Tax District 5o DOR Use Code THEATER /AU (003200) Market Area 40 The DOR Use Code shown here is a Dept. of Revenue code. Please contact the Okeechobee County Planning & Development office at 863 -763 -5548 for specific zoning information, Mkt Land Value cnt: (2) $404,505.00 Ag Land Value cnt: (0) $0.00 Building Value cnt: (1) $244,506.00 XFOB Value cnt: (8) $79,432.00 Total Appraised Value $728,443.00 Page 1 of 2 2015 Certified Values Parcel List Generator Retrieve Tax Record Property Card 2015 TRIM (pdf) Interactive GIS Map Print Search Result: 1 of 1 4 I!O _ 71; If f Just Value $728,443.00 Class Value $o.00 Assessed Value $728,443.00 Exempt Value $o.00 Total Taxable Value $728,443.00 Show Similar Sales within 1/2 mile Fill out Sales Questionnaire Sale Date Book/Page Inst. Type Sale Vimp Sale Qual Sale RCode (Code List) Sale Price 10/24/2012 721/733 QC I U 11 $100.00 4/1/1990 316/1278 QC I U 03 $0.00 7/1/1987 288/1302 WD V U 03 $0.00 1/7/1986 280/925 V U 03 $0.00 1/1/1973 145/341 WD V U 03 $0.00 1/1/1973 144/45 WD I Q $57,500.00 5/1/1972 138/537 WD V U 03 $0.00 Bldg Sketch I Bldg Item Bldg Desc Year Bit Heated S.F. Actual S.F. Bldg Value Show Sketch 1 AUDITORIUM (006000) 1974 12081 14208 $244,506.00 Code Desc Year Bit Value Units Dims Condition (% Good) SPRINK WET PIPE 1974 $14,728.00 0012852.000 0 x 0 x 0 PD (060.00) http://www.okeechobeepa.com/GIS/D SearchResults. asp 2/8/2016 D tail by Entity Name FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS .. k Detail by Entity Name Page 1 of 3 Florida Not For Profit Corporation THE UNITED PENTECOSTAL CHURCH OF OKEECHOBEE, INC. Filing Information Document Number N31717 FEI /EIN Number 65- 0165539 Date Filed 04/14/1989 State FL Status ACTIVE Last Event REINSTATEMENT Event Date Filed 06/08/2015 Principal Address 405 SW 10TH AVE OKEECHOBEE, FL 34974 Changed: 07/05/2007 Mailing Address 13333 NE 7TH TERR OKEECHOBEE, FL 34972 Changed: 07/30/1998 Registered Agent Name & Address Warren, Rev Raymond, cd 13333 NE 7TH TERR OKEECHOBEE, FL 34972 Name Changed: 06/08/2015 Address Changed: 07/30/1998 Officer /Director Detail Name & Address Title CD WARREN, RAYMOND REV 13333 N E 7TH TERRACE OKEECHOBEE, FL 34972 http: / /search. sunbiz.org/ Inquiry/ CorporationSearch /SearchResultDetail ?inquirytype= Entity... 2/8/2016 Dctail by Entity Name Title STD WARREN, ANNA M 13333 N E 7TH TERRACE OKEECHOBEE, FL 34972 Title D ORTEGA, JOSE 3617 SW 18TH ST OKEECHOBEE, FL 34974 Title D POPE, CANDACE A 784 S E 25TH ST OKEECHOBEE, FL 34974 Title D WARREN, KIRK A 2048 NW 38TH AVENUE OKEECHOBEE, FL 34972 Title D CLARKE, BRYAN 6668 N E 2ND ST OKEECHOBEE, FL 34974 Annual Reports Report Year Filed Date 2013 01/25/2013 2014 06/08/2015 2015 06/08/2015 Document Images 06/08/2015 -- REINSTATEMENT 01/25/2013 ANNUAL REPORT 01/06/2012 -- ANNUAL REPORT 01/19/2011 -- ANNUAL REPORT 05/03/2010 -- REINSTATEMENT 02/09/2008 -- ANNUAL REPORT 07t05/2007 -- ANNUAL REPORT 01107/2006 -- ANNUAL REPORT 01/17/2005 -- ANNUAL REPORT 01/0612004 ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Page 2 of 3 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype—Entity... 2/8/2016 Detail by Entity Name O4/21/2Q03— ANNUAL REPORT 05/3020D2— ANNUAL REPORT O5/17/2OO1— ANNUAL REPORT ANNUAL REPORT U5/O5/Y989— ANNUAL REPORT 07/30/1998 -- ANNUAL REPORT 01/.230997_7 ANN1UAL REPORT 06/24/1995— ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Page 3 of 3 St-3te F.cr:da. of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/8/2016 UNITE -6 OP ID: S2 ACORel' CERTIFICATE OF LIABILITY INSURANCE 4....----- DATE(MMIODrYYY) 02108!2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Pritchards & Associates, Inc. 1802 S Parrott Ave Okeechobee, FL 34974 -6179 Lowell H Pritchard NAME: ACT Sandy Hines PHONE FAX (Alc, No, Ext): 863- 763 -7711 (NC, No): 863- 763 -5629 ADDRESS: shines @pritchardsinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Ins 18058 INSURED The United Pentecostal Church of Okeechobee, Inc. 13333 NE 7th Terrace Okeechobee, FL 34972 INSURER B : Progressive Express Ins Co 10193 INSURER C: 03/13/2016 INSURERD: $ 1,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SU W ER VD POLICY NUMBER EFF (MMIDDIYYYY) POLICY EXP MIPOLICY (MDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK1311591 0311312015 03/13/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 100 000 $ 100,000 EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS 06476164 -7 07/10/2015 07/10/2016 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 100,000 BODILY INJURY (Per accident) $ 300,000 PROPERTY DAMAGE (Per accident) 50,000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 1 N N l A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) CANCELLATION CITY -92 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c r/ 6 1. ACORD 25 (2014/01) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD D & K Enterprises of Okeechobee, Inc. Brahman Theaters 1I1 P.O. Box 1395 Okeechobee, Florida 34973 To Whom It May Concern: jv I, Karla H. Roby and Debra S. Sales, owners of The Brahman Theatres III, located at 1860 S. Parrott Avenue in Okeechobee. Give permission for Pentacostals of Okeechobee, the use of our parking lot on Friday, February 12th, 2016 for a BBQ benefit. Best Regards, Karla H. Roby 014 Debra S. Sales CL :LL VN` - t /L'. fY -(.��.� L0-1 .kiuth�. i �.� -) &e3 lc 3`f Googleearth feet meters 10 4 When: Friday, February 12th, 10am -2pm Where: Brahman Movie Theatre Parking Lot Missions Trip BBQ Fundraiser All money raised will help support Carly Enfinger on her missions trip to Brazil in June . $10 Dinner (pork, baked beans, potato salad & roll) -Will deliver with purchase of 5 or more dinners For information or to purchase tickets call /text Carly at (863) 801 -4042 or Lauren at (863)801 -3632 nd he said unto them, " Go e into all the world, and each the gospel to every eature." Mark 16:15 3