Temp. Use Permit - Faith Alive Fellowship BBQCity of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
(863) 763 -3372
Temporary Use Permit
Permit Number: 16 -005
Permit Expiration: June 24, 2016 11:59PM
Purpose of Request: Barbeque Fundraiser
Property Owner: Karla Roby & Debra Sales
Address: P.O. Box 1395
City: Okeechobee
Date(s) of Event: June 24, 2016 11AM - 3PM
State: Florida Zip Code:34974
Applicant: Faith Alive Fellowship Applicant's Address: 3075 SW 3rd Terr., Okeechobee
Phone Number: 863 -634 -2764 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.
ant's Signature
Sack ie Jun/tam
General Services Assistant
Date: 00 - 16
June 22, 2016
Date
CITY OF OKEECHOBEE
General Services Department, Room 101
55 Southeast 3rd Avenue
Okeechobee, FL 34974
e: 863-763-3372 ext. 218 Fax: 863-763-1686
TEMPORARY USE PERMIT APPLICATION
TR TURES sEC 666
APPLICANT I
Name of Property Owner(s): .
DATE RECEIVED:
/.
i ii (/.
•
ISSUED:
t ■11e..
i.,...141k! gil
! "n4r,....r '
— ,
APPLICATION NO: ,
16.
..
r r
DATE(S) OF EVENT
\ 4 P a
FEE: $175.00 DATE PAID: .
ol If Non-Profit/Civic Organization N iiji
TEMPORARY USE PERMIT APPLICATION
TR TURES sEC 666
APPLICANT I
Name of Property Owner(s): .
Legal Description of Property: it.in. 1.41,1i), , t ‘,1 ,,, ‘54,,,,i, 1 , 0, i , 0
4...,
Address of Property:
-:- ,
Please Explain Type of Use: i
Briefly describe use of adjoining property: •
North: East:
South: West:
Address:
1,,,, ;,-; Jr / „,...---,
. , ( .7--7
., .
7.7 Y
i
Date:
• .(:::, - .,(:. 1 •
i<--
Telephone Numbers: Home:
Work:
,-----
Mobile/Cell:
.
Pager:
Name of Applicant:
//'' /
''
;
. .
- /
/
.
Address:
.
Building Inspector Appro —
,
Telephone Numbers: Home:
Work:
Moblie/Cell:
'
Pager: n1.
PROPERTY
Future Land Use Map Designation: Current Zoning Designation:
Legal Description of Property: it.in. 1.41,1i), , t ‘,1 ,,, ‘54,,,,i, 1 , 0, i , 0
4...,
Address of Property:
-:- ,
Please Explain Type of Use: i
Briefly describe use of adjoining property: •
North: East:
South: West:
Other temporary structures subject to the following regulations:
1. Christmas 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. Commercial 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:
I 1. Submit proof of liability insurance, pald 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
... Have notarized written permission of property owner, If applicant is not the property owner.
4. Submit Site Plan *
'5. Submit Statelnepeetion Certificate(s) *
6. Submit State Annual Permit . . .. .. . .. a• I t_ . -- 1—...“......
hereby certify that the information on this application Is correct. The lnformatlon lnclue In mis app
City of Okeechobee In processing my request. False or misleading information may be punishable by a fine of up to $500.00
and imprisonment of up to thirty days and may result in the summary denial of this application.
Si
ture ofciIcant
• •
Date
ulty -tan- knease I tIVICPIV tl itzr zivpait..caLoas,, coActv■ 4 WV' llllll VI 14,4 44.4. ...r.---
--•........_._ .
Occupational and/or State License Verification: ; r;
nuy—,-Kfuvii
Date: .
,,, ?). _/(:,..-,
Fire Department Approval:
1,,,, ;,-; Jr / „,...---,
. , ( .7--7
., .
7.7 Y
i
Date:
• .(:::, - .,(:. 1 •
i<--
c , 'e72,/c .S•
" • ; - • - - Approval:
,-----
I
.
Date: 22 -/
17
_
•
VULIc Works Department A• •
;
. .
- /
/
.
D ate:
Building Inspector Appro —
Date:
City Administrator Approval:. .
(""
—
_....— ..
Date: ,../ ...--
/ iv/ ("6-i•
Revised 21110B tile
D & K Enterprises of Okeechobee, Inc.
Brahman Theaters III
P.O. Box 1395
Okeechobee, Florida 34973
6/21/16
To Whom It May Concern:
I, Karla H. Roby and Debra S. Sales, owners of The Brahman Theatres III, located at 1500
S. Parrott Avenue in Okeechobee. Give permission for Faith Alive Fellowship, the use of our
parking lot on Friday, June 24th, 2016 for a BBQ Fundraiser.
Best Regards,
Karla H. Roby
di
Debra S. Sales
.471K .... ti, JUDY T. WILCOX
,i. 1 : MY COMMISSION Y FF 931209
.• r:�; EXPIRES: October 27, 2015
Bonded Thru Notary Public Underwriters
DEPARTMENT
OF REVENUE
Consumer's Certificate of Exemption
Issued Pursuant to Chapter 212, Florida Statutes
DR -1
R. 04/1
85- 80155224160 -9
12/31/2015
12/31/2020
501(C)(3) ORGANIZATION
Certificate Number
This certifies that
JOHN WILCOX MINISTRIES INC
3075 SW 3RD TER
OKEECHOBEE FL 34974 -5916
Effective Date
Expiration Date
Exemption Category
is exempt from the payment of Florida sales and use tax on real property rented, transient rental property rented, tangibl
personal property purchased or rented, or services purchased.
DEPARTMENT
OF REVENUE
Important Information for Exempt Organizations
DR -1
R. 04/1
P, :01•'UU1
„"....'"r—w JOHNW-3 OP ID: ME
,A�C•df�er„+� � DATE,tMfAtGDlYYYQ
+ - CERTIFICATE OF LIABILITY INSURANCE oQ,orjxale
THIS CERTIFICATE -IS ISSUED AS A MATTER 'OF INFORMATION ONLY AND 'CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS'
r THE ,ROUCIES
BELOW. THIS CERTIFICATE , F iNSURAN a .DO $ NOT LCON CONSTITUTE CONTRACT' BETWEEN THE I88WN3F NSURER(S},7A14110RIZE0
REPRESENTATIVE OR PRODUCER, AND THE CER • IFICATE HOLDER.
IMPORTANT. ► the crrilfIcals holder Is an ADDITIONAL INSURED, the Dllc lea} must be endnread. If SUBROGATION! 13 WAIVED, subject to
P Y( N.
the tonne and'eoridltions of the policy; 'certain oollc,les may require an endorsement: ,A etatarnant an'thta certiflcate does not confer to the
certl8cate holder's Ileu of such endarsemant s
PROOUC*R
$U Lawrence Insurance Nieney
POEM 548
Okeechobee,- FL 34873
Heath Lawrence
7741:u Tltn tcox Ministries abe
Faith Alive Mli1l rles
3075 SW 3rd Tart ace
Okseehobee, FL 34974
COVERAO Es
INSOREFt_SLAFFORDING COVERAG!
INSURER A':Aii1BrIQan Stone lnsuranc9 Co
NAIL •
10704
IFICATE NUMBER: ncnalvn narnncrc:
r' j$ IS TO CERTIFY MAT THE pDLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERl ti
NDICATED, NOTAWITISTANDING A*P(' REOUIREMENT,''TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TC.WHICH T-tls
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLIOIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXcluv nts'AND CONDITIONS OF SUCH FOLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPICFINSURANC? JN.PT"Ttr ;;toy„Nta>Lt tg -- _ _ednVD___[ t,;t~.r11:'L ree
all N MVO, LIA61LrTY
A X r:nvivERCI ALGENERALLIA &LITr
ti-MACE Xj UC'C,I'
'INSURPIR C':
1NBU Rd;
INSURER e ;
INeUR$RF'.
GEN'L AGGREGATE LI 'NIT APPLIES PER-
Poi ICr I eR°.
LOC
AUTOMOSILE LIABILITY
j—::
ANY, AUTO
, ALffo8 AUTOS
MAEDAUTOS ,,,,,I AU!'OS
UMl3RELtA LIAR
hXC6e1UA6
DEO
outp
CLAMS -MAt3”
WORMERS COMPENSATION'
kV EMPLOYERS' LIABILITY
ANY PROPACtdR ,PARVE.R.+E'ME'cunvE. rr--�
R'
OIFICEaNaso R exCLUaErr
(Modem In NH)
Se.RI ra <SF ;CPA/1CM belenr
O1CH43481600
04/04/2018
04104/2017
N/A
r--
EACH OCCW7RENCE
1.40171
RM a cccvrnncel
mEO EXP (A.ty one per
PERSONAL 6' CV INJUFIY
GENERAL AOOREOAT2
PRODUCTS • COPoIP /OP Ant
1X00.00
p 1,000,000
t 10,0E0
1,000,20E
0 1 2,000;000
$ I 2,1200,000
ecci.. r.
94Dr.Y INJURY (Pa : es n)
E.
SONLY INJURY.'Pet eesldirt
Y +7....•r. ;.,
d I
EACH OCCURRENCE
AGGREGATE
6
w ;STA lir.
eACH •ACCIDENT
E.t. DISEASE - EA EMPLOYEE
018EASE • POLICY LIMIT
D66 CRIPT1ON CF OPtlRATICNa t LOCATIONS / YEI -IICLES (Attach ACORO ID1, AtitlIonal RemerRe $ehedule, a more apace h rep ulrad)
ClITJR,CHES OR on-am Rovers or WORSHIP
CERTIFICATE HOLDER
ON
ACCRD 25 (2010/05)
CHOULD 14NY or THE AsoVC DEBCRICEDPOLICIES on CM4c84,sio weevils
T4(It EXPIATION 'DATE THEREOF, NOTICE WILL OM 'oeuv Ito IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZE:, FLEPRIFATifUTAYNr
(019804010 ACORO CORPORATION. All'r;ghtd reserved.
The ACORID name and 1oou ere regis tered marks of ACDORD
Okeechobee County Property Appraiser Map Printed on 6/21/2016 1:18:02 PM
6/21/16, 1:17 PM
3-28�7-05-0850-00290-0010
eO0YKARL4M& SALES DEBRA S
2 D8OAc
142.5
SW 17TH ST
r ^upeK ppx����'
vvc "Bmr crx 77-. 4.472
PARCEL: 3-28-37-35-0050-00290-0010 THEATER/AU (003200)
FIRST ADDITION 10 SOUTH OKEECHOBEE BOOK 1 PAGE 17) LOTS 1
TO 12 INC & ALLEY BLOCK 29
Name: ROBY KARLA H & SALES DEBRA S LandVal y404,505.00
Site: 1600 ap«nnoTT*xe.oxss:HoaEE am«va| $244.506.00
Man 1906 SW 5TH AVE ApprVal $728,443.00
OKEECHOBEE, FL 34974 JustVal $728.4*300
Sales
Info
Assd �28�3.00
Exmpt $0.00
Taxable $728.443n0
" 217 / 514
81 ft
This information, updated: oo/2n1u. was derived from data which was compiled by the Okeechobee County Property Appraiser's Office
solely for the governmental purpose of property assessment. This information should not be relied upon by anyone as a determination of the
ownership of property or market value. No warranhies, expressed or implied, are provided for the accurac of the data horem.u'suoo.v,/ro
interpretation. Although it is periodicauy updated, this information may not reflect the data currently on file in the Property Appraiser's offi�.
xnn. .com/Gm/pxnuwan.asp/pjuw//uc»mun//ooar'»oa«omum/enm,vnmommuonhmmuccneij/nvapfoomnuxoovoNpkxh000cu Page 1 of 2