Temp. Use Permit - More 2 LIfe BBQCity of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
(863) 763 -3372
Temporary Use Permit
Permit Number: 16 -006
Permit Expiration: July 15, 2016 11:59PM
Purpose of Request: Barbeque Fundraiser
Property Owner: Karla Roby & Debra Sales
Address: P.O. Box 1395
Date(s) of Event: July 15, 2016 3AM – 3PM
City: Okeechobee State: Florida Zip Code: 34974
Applicant: More to Life Ministries Applicant's Address: 605 SW Park St. Ste 214 Okeechobee
Phone Number: 863 - 801 -1871 Address of Project: 1600 S Parrott Avenue
Current Zoning: Heavy Commercial (CHV FLU Designation: Commercial (C)
Subdivision: 1 — Addition to South Okeechobee
Restrictions /Remarks: All debris must be removed upon final completion date.
Owner understands and agrees to the following:
Issuance of a permit may be subject to other conditions and time limitations.
Issuance of a permit is not authorization to violate public or private restrictions.
Failure to comply with applicable regulations may result in withholding future permits.
There may be additional permits required from other governmental entities.
Applicant's Signature
�acckie Dunham
General Services Assistant
REF: .ORD.716, Temporary Structures
Date: / I i/ \
July 12, 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
,..z...
lame of Property Owner(s): M f.
DATE RECEIVED: rl i 1 DATE SSUED: 7 1 2, i
. mv. , 8,......
.., ..,..,r7.,..
APPLICATION NO: ,... .
$j OF EVENT:
1,1,..,:_ ,,., ■ u DATE((4
FEE: $175.00 DATE PAID:
o/ If Non-Profit/Civic Organization NI+
TEMPORARY USE PERMIT APPLICATION
OTHER TEMPORARY STRUCTURES SEC 666
•
APPLICANT
lame of Property Owner(s): M f.
c, :1 Cs c..k, (( 1 vi C .
, I ,
Address of Property: 1 t cs,,, ;',
Please Explain Type of Use: , 3 /, It '.(1 ■ -:■ ' `,:1 l' --I (I' ,I.,1 i' 11 Loi
• #
Briefly describe use of adjoining property:
North :1„1.:1- 1, '' , ' i I I, 1 0 ,,4, 't ' ' , 1,,' I ' ' East i I , rt a,',,,
South: bry cliv,0,4 5 _ (:1 0, . ,L,1,,r1,, t, , ,i, - ti )1,`West t\ ,',. h., t /
Address: ( c.)„s f; No f k,
/
_ C '
4( (■t S—\, . j V-1 ',( S Y
C,''•
‘.
H
'i
) J,
Telephone Numbers: Home:
Work:'i,:,‘ , '--lf,s, - \ -Mobile/Coll:
•
Pager:
----,/
i\Jame of Applicant -, ,,-, 1
Date:
7 b.
--, - '', '-, c ` 1-1
,,
Building Inspector Approval:
6-
Address: ,,, ), f 0, rt
/,- /: , t /
City Administrator Approval: / .
t i
Telephone Numbers: Home:
Work: Moblle/Cell:
Pager:
PROPERTY
1
Future Land Use Map Designation: Current Zoning Designation: /
. 4 , 1 , , •
Legal Description of Property: i 3 V, -I I' i`TA ' 4"1 ' ' , '.-"- P
, I ,
Address of Property: 1 t cs,,, ;',
Please Explain Type of Use: , 3 /, It '.(1 ■ -:■ ' `,:1 l' --I (I' ,I.,1 i' 11 Loi
• #
Briefly describe use of adjoining property:
North :1„1.:1- 1, '' , ' i I I, 1 0 ,,4, 't ' ' , 1,,' I ' ' East i I , rt a,',,,
South: bry cliv,0,4 5 _ (:1 0, . ,L,1,,r1,, t, , ,i, - ti )1,`West t\ ,',. h., t /
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:
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 *
I 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 Information may be punishable by a fine of up to $500.00
1 prlsonmen of vijU o thirty ays and may result in the summary denial of this application.
/ /
\\.
Signet of Applicant
City Staff (Please review the appflcation, attach comments or special conditions):
Date
Occupational and/or State License Verification:
Date:
Fire Department Approval:
;
Date: .
414020/4
Date:
,
Police Department Approval: ,
•
----,/
.
Date:
7 b.
Public Works Department Approval:- - ,.---T
/
___—,---
Building Inspector Approval:
6-
(i; /
Date: —1 , /2
i
City Administrator Approval: / .
t i
Date:/ ,,,
, L
Revised 2/1108 blc
Okeechobee County Property Appraiser - Map Printed on 7/8/2016 10:47:30 AM
Page 1 of 1
{
rn
3- 28- 37 -35 -005
ROB ARLA H & SALES
2.0.. AC
i..�u_ s_ :
142.5
1425
SW 17TH ST
1
S I. VP ALAN Sft
Okeechobee County Property Appraiser
W.C. "Bill" Sherman, CFA - Okeechobee, Florida - 863 - 763 -4422
PARCEL: 3- 28 -37 -35 -0050- 00290 -0010 - THEATER/AU (003200)
FIRST ADDITION TO SOUTH OKEECHOBEE (PLAT BOOK 1 PAGE 17) LOTS 1
TO 12 INC & ALLEY BLOCK 29
Name:ROBY KARLA H & SALES DEBRA S
Site: 1600 S PARROTT AVE, OKEECHOBEE
Mail:
Sales
Info
1906 SW 5TH AVE
OKEECHOBEE, FL 34974
LandVal
BldgVal
ApprVal
JustVal
Assd
$404,505.00
$244,506.00
Exmpt
Taxable
$728,443.00
$728,443.00
$728,443.00
$0.00
$728,443.00
I 1
27 54
81 ft
%V
I �
This information, updated: 6/23/2016, 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 warranties, expressed or implied, are provided for the accuracy of the data herein, its use, or
it's interpretation. Although it is periodically updated, this information may not reflect the data currently on file in the Property Appraiser's
office. The assessed values are NOT certified values and therefore are subject to change before being finalized for ad valorem assessment
purposes.
http://www.okeechobeepa.com/GIS/Print Map. asp ?pj boiibchhj bnligcafcefocnfkfdfefdbblej ... 7/8/2016
Brahman Theatre III
1600 S Parrott Ave
Okeechobee, FL 34974
To Whom it May Concern:
More 2 Life Ministries, Inc has permission to have a BBQ fundraiser for their youth
group on Friday, July 15th from 3am to 3pm in the parking lot of the Brahman Theatre III
property.
Thank you,
Phone:
Date:
0000059 11/15/11
FLORIDA
Sr • 1!
DEPARTMENT
OF REVENUE
Consumer's Certificate of Exemption
Issued Pursuant to Chapter 212, Florida Statutes
DR -14
R. 04/11
85- 80137550160 -7
02/29/2012
02/28/2017
501(C)(3) ORGANIZATION
Certificate Number
This certifies that
MORE 2 LIFE MINISTRIES INC
605 SW PARK ST STE 213
OKEECHOBEE FL 34972 -4173
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, tangible
personal property purchased or rented, or services purchased.
DEPARTMENT
OF REVENUE
Important Information for Exempt Organizations
DR -14
R. 04/11
1. You must provide all vendors and suppliers with an exemption certificate before making tax - exempt purchases.
See Rule 12A- 1.038, Florida Administrative Code (F.A.C.).
2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's
customary nonprofit activities.
3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be
reimbursed by the organization.
4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible
personal property, sleeping accommodations, or other real property is taxable. Your organization must register,
and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this
requirement except when they are the lessor of real property (Rule 12A- 1.070, F.A.C.).
5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no
circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for
payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third - degree
felony. Any violation will require the revocation of this certificate.
6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account
Management at 800 - 352 -3671. From the available options, select "Registration of Taxes," then "Registration
Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480,
Tallahassee, FL 32314 -6480.
MORE2 -1
OP ID: S2
ACORO CERTIFICATE OF LIABILITY INSURANCE
1/4.-----
DATE(MMroD1YYYY)
07/11/2016
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
CONTACT
NAME: Sand/ Hines
PHONE FAX
AIC No Ex • 863- 763 -7711 ac, No 863- 763 -5629
ADDRESS: shines @pritchardsinc.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA:Auto Owners Insurance Co.
18988
INSURED More 2 Life Ministries, Inc.
605 SW Park St Ste 214
Okeechobee, FL 34972
INSURER B: Florida Citrus, Business & Ind
25CC38518110
INSURERC:The Ohio Casualty Insurance Co
24074
INSURER D :
$ 1,000,000
INSURER E
$ 1,000,000
INSURER F :
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
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MMIDDIYYYY)
POLICY EXP
(MMIDDIYYYY)
LIMITS
C
X
COMMERCIAL GENERAL LIABILITY
X
25CC38518110
11/11/2015
11/11/2016
EACH OCCURRENCE
$ 1,000,000
DAMAGE To RENTED
PREMISED (Ea occurrence}
$ 1,000,000
CLAIMS -KIA E
OCCUR
MED EXP Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L
AGGREGATE
POLICY
OTHER.
LIMIT APPLIES
PRO-
JECT
PEP
LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE
-
X
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
BUSINESS
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS
5049898900
10/06/2015
10/06/2016
COMBINED SINGLE LIMIT
(Ea accident)
$ 300,000
BODILY INJURY Per person)
$
BODILY INJURY (Per accident
$
PROPERTY DAMAGE
(Per accident)
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
$
DED
RETENTION $
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER E!CLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
106-44532
04/01/2016
04/01 /2017
X
STATUTE
OTH-
ER
E L EACH ACCIDENT
$ 100,000
E L. DISEASE - EA. EMPLOYEE
$ 100,000
E.L. DISEASE - POLICY LIMIT
500 000
$ 500,000
Property Section
25CC38518110
11/11/2015
11/11/2016
DESCRIPTION OF OPERATIONS i LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holer is listed as Additional Insured in regards to the General
Liability Policy Form Number CG76350207.
CANCELLATION
CITY -92
City of Okeechobee
tY
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
ACORD 25 (2014/01)
@ 1988 -2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD