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Grand Re-Opening Murray InsuranceCity of Okeechobee 55 S.E. 3rd Avenue Okeechobee, Florida 34974 (863) 7633372 Temporary Use Permit Permit Number: 17 -002 Permit Expiration: March 18, 2017 11:59PM Purpose of Request: Grand Re- Opening Property Owner: Murray Insurance Address: 210 SW 2nd Street City: Okeechobee Date(s) of Event: March 18, 2017 12PM — 2PM State: Florida Zip Code: 34974 Applicant: Shannon Murray Applicant's Address: 10770 SE Jupiter Narrows Phone Number: 863 - 357 -6246 Address of Project: 210 SW 2nd St Current Zoning: Central Business District (CBD) FLU Designation: Commercial (C) Subdivision: City of 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. I certify that I have examined this permit, it is correct and I will abide by its requirements. Applicant's Signature General Services Assistant REF: .ORD.716, Temporary Structures Date CITY 01? OIKEECHOBEE General Services Department, Room 101 55 Southeast 3' Avenue Okeechobee, FL 34974 Phone: 863- 763 -3372 ext. 217 Fax: 863 -763 -1686 TEMPORARY USE PERMIT APPLICATION OTHER TEMPORARY STRUCTURES (SEC 666 APPLICANT DATE RECEIVED: _ / 0}- / 7 DATE ISSUED: 3_ i 14, - I 0. -,-„ _ `,.1,0 .,. eFC~ 4,,,,,... .,... .:..on, ,o fI',I�, -._" 5; .., ;•� /zP APPLICATION NO i -QOif DATE(S) OF EVENT: 3 -1 i _ P FEE:. $175.00 • DATE PAID: ; T ❑,r If Non- Profit/Civic Organization N "��' "� STR�� ' i =� : °•,' TEMPORARY USE PERMIT APPLICATION OTHER TEMPORARY STRUCTURES (SEC 666 APPLICANT Name of Property Owner(s): . JJ n ,.,,,,,t 6 . /i'( , rrr fil. v rrc fit/ti, , c _k vtv/ 4._ -f• e..1 Address: C 77 it 'i re-A 441MC4 t,' 1; WOE/ Scu.nO` _ • C.` "3'`'s- 5 Telephone Numbers: Home: Work: 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 notthe property owner. 4. Submit Slte Plan * 5. Submit State inspection Certificate(s) 6. Submit State Annual Permit * • ' 77= Mobile /Cell: cy ,3 Pager: Name of Applicant: �►K`e 0 &i A r ,,. &,- -L%C:-: i Address: . y `3 % ; e .- / 3 Telephone Numbers: Home: Work: :457 -L,2.1-14, Mobile /Cell: Pager: 'T 'li%�Pi•i'1 i7�•l j •7 hereby certify that the information on this application is correct. The Information included �n this app licat�an is for use by the City of Okeechobee in processing my request. False or misleading information maybe punishable by aline of up to $500.00 and Imprisonment of up to thirty days and may result in the summary denial of this application. • SIgRatUre of Applicant Cit Staff Please review the a Icatlon, attach comments or saeclal conditions : Occupational and /or State License Verification: W Date /f 2 xOther Gu 0 t. Future Land Use Map Designation: CAM ML AL, 4 LCurrent Zoning Designation: �8 D Legal Description of Property: c=; S `1 e it ©A�:GC No 6i:6 I.cT3 4 '+-[ c • B L. c4-A / le S' Address of Property: ,<o site 2mJ .�iA r e e re /,....z. Please Explain Type of Use: : C i , , " .. ,�� x - �, d �. Briefly describe use of adjoining property: / North: �3 Mey, &A y East: k;. eAet�s.,4 t South: S-fjr„ e_.,-7-- West: 1t�j� —'i�lh r- 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 notthe property owner. 4. Submit Slte 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 �n this app licat�an is for use by the City of Okeechobee in processing my request. False or misleading information maybe punishable by aline of up to $500.00 and Imprisonment of up to thirty days and may result in the summary denial of this application. • SIgRatUre of Applicant Cit Staff Please review the a Icatlon, attach comments or saeclal conditions : Occupational and /or State License Verification: W Date /f 2 q v e 1;4 0 Q RE OPEN NG We've moved back to our original location where it all started 43 years ago! ILA MURRAY INSURANCE SERVICES 210 SW 2ND ST Okeechobee FL 34974 Featuring WOKC Okeechobee's TRUE Country BROADCASTING LIVE! PLUS FOOD * RAFFLES DOOR PRIZES Just bring a nonperishable food item for our food drive! th Starts at NOON! MURRAY INSURANCE SERVICES 210 SW 2nd St., Okeechobee FL 34974 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 3/9/2017 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 15 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 Murray Insurance Services, Inc. 1149 SW 34th St PO Box 367 Palm City FL 34991 INSURED Murray Insurance Services, Inc PO Box 367 Palm City FL 34991 CONTACT NAME: House Account PHONE (772) 287_1411 (A/C Nom Ext): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INsuRER A :Bankers Insurance Company INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : 1 FAX (A/C, No): (772)283 -0106 T NAIC # COVERAGES CERTIFICATE NUMBER:CL173901009 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 TYPE OF INSURANCE LTR ADDL SUBR INSD 1 WVD POLICY EFF POLICY NUMBER (MM /DD/YYYY) POLICY EXP T (MM /DD /YYYY) LIMITS X 1 COMMERCIAL GENERAL LIABILITY 5/27/2017 EACH OCCURRENCE - DAMAGE TO RENTED ,_ PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $ 2,000,000 $ 50,000 $ 5,000 $ Included 1 CLAIMS - MADE X OCCUR i 09 0004986871 7 05 5/27/2016 GEN'L AGGREGATE LIMIT APPLIES PER: $ 4,000,000 X POLICY PRO- JECT 1 LOC OTHER: $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED 'AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) $ $ $ PROPERTY DAMAGE _ (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE $ $ $ DED i i RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N -------L, - _.J - - - N / A I PER OTH- ' STATUTE ER E.L. EACH ACCIDENT $ - - - - - - -- E.L. DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) . t _ — _ ^_._ - IV s__ �.1�t' -d'r �.�' t ., CANCELLATION City of Okeechobee 55 SE 3rd Avenue 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 Shannon Murray /SM �w _ %'� ACORD 25 (2014/01) INS095 r2nlann ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FIRST COMMUNITY INSURANCE COMPANY BBOP99.001 1007 1007 PO BOX 33060 00- 0050434 ST. PETERSBURG, FL 33733 -8060 800-627-0000 Policy Number 09 0004986871 7 05 Additional Interests CITY OF OKEECHOBEE 55 SE 3RD AVE OKEECHOBEE, FL 34974 -2903 DESIGNATED PERSON OR ORG. W (74 e, wet e Fire and Emergency Services Departent 55 SE 3«' avenue Okeechobee, Florida 34974 Telephone: (863) 467 -1586 Fax: (863) 763 -4489 www.cityofokeechobee.com 2017 Tent Guidelines All tents 200 Square Feet or larger shall have a current (within the last 12 months) Florida or Other State Certified (minimum rating of 2A:10B:C) portable fire extinguisher. All Cooking tents (re <gardless of size) shall require a current Florida or Other State Certified Class "K" portable fire extinguisher in addition to the 2A:10B:C extinguisher. If you do not have a certified fire extinguisher, one may be purchased from any Fire and Safety equipment company. ** *Fire extinguishers purchased from many retail stores are not certified and will not be accepted. Fire Extinguishers can be "shared" in a common area used by multiple cooking tents if necessary. The travel distance should not exceed 75 feet. 2. Tents must be Flame Retardant and shall meet the flame propagation performance criteria specified by NFPA 701. All tents must be certified by an approved testing agency and the vendor shall provide evidence of the flame spread certification. Keep the tag on the tent visible when setting up the tent for ease of inspection. * * *Non -Flame retardant tent fabrics or materials such as retail store camping tents or tarps do not meet the NFPA 701 Standard and will not be accepted. 3. "Cooking Tents" must be located a minimum of 5ft away from buildings and other tents and must be located a minimum of 10 feet away from any "Public Use Tent ". "Public Use" in this case is defined as "If the public can enter under the tent to congregate, sit, view merchandise, or any other activity that allows anyone from the public to enter under the covered tent area." 4. "Cooking tents" shall be open on all sides, free from grease residue, and arranged to keep the cooking appliances away from the public. LP Gas Cylinders shall be located a minimum of 511 away from the cooking appliance & tent, protected from traffic, and secure always. 5. All cooking equipment must be in good working condition and adhere to the testing agency label that certified the equipment. Deep -fat fryers shall be equipped with a separate high - limit control in addition to the adjustable operating control (thermostat) to shut off fuel or energy when the fat temperature reaches 475 °F (246 °C) at 1 in. (25.4 mm) below the surface. 6. Electrical Fire Safety as it relates to the use of temporary wiring, extension cords, overloaded circuits, etc. will be evaluated on a case -by -case basis for compliance. All equipment used during the event must be in good, safe working condition. The life safety codes governing tents, portable seating, portable structures, and temporary activities are far too numerous to list. This is only a summary of some of the guidelines. During the inspection process and at any time during the event, if a situation is deemed "unsafe" by Fire or Code Enforcement personnel, it will be required to be corrected immediately. If this is not done, the permit may be revoked, at the discretion of the AHJ. Public Safety is our foremost concern. We wish everyone a safe and enjoyable event. If you have any questions you may contact the Fire Department at 863- 467 -1586. Service doesn t come from a manual —it comes from the heart. 40.oc c) Sprint LTE < Search 12:22 PM 13 Messages ‘‘. Flame Certificate JL • ILA . "IL/ -' e-mail: altentsstructure(aThellsouth.net Certificate of Flame Resistance Registered Fabric or Concern Number F-12123 Issued By: Trivantage, LLC 1831 North Park Ave. Glen Raven NC 27217 Date treated or manufactured. 09/16/2013 mis s to certify that the materiels descnbed below have been treated with a ffame-reterdant chemical or are ■flheren/iy nonflammable FOR: Trivantage, LLC kni)121 1831 North Park Ave crn Glen Raven Ari. NC 27217 Certification is hereby made that (Check "a" or "V) (a) The articles described at the bottom of this Certificate have been treated with a flame-retardant t:hernicat approved and registered by the State Fire Marshal and the application of said chemical was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal Name of chemical used Chemical Registration ft Method of application: (b) The articles described at the bottom of of this Certificate are made from el fiarne-reSistant fabric or matena X i registered and approved by the State Fire Marstial for such use Trade Name of Stacie-resistant fabric or material used RENTERS CHOICE 16 OZ Registration 5 F-12123 The Flame-Retardant Process Used Will Not Be Removed By Washing ALBERT E JOHNSON Name of Applicator or Production Superintendent VICE PRESIDENT BUS DEVELOPME RCN # 100 968340 16 103 968340 16 79 CUSTOMER ORDER NO. FRED / ROAD SAL CUSTOMER INVOICE NO, 266852 YARDS OR QUANTITY 1000 00 2 Exempt Organizations Select Check IRS Page 1 of 1 Exempt Organizations Select Check Exempt Organizations Select Check Home Organizations Eligible to Receive Tax - Deductible Charitable Contributions (Pub. 78 data) - Search Results The following list includes tax - exempt organizations that are eligible to receive tax - deductible charitable contributions. Click on the "Deductibility Status" column for an explanation of limitations on the deductibility of contributions made to different types of tax - exempt organizations. Results are sorted by EIN. To sort results by another category, click on the icon next to the column heading for that category. Clicking on that icon a second time will reverse the sort order. Click on a column heading for an explanation of information in that column. 1 -1 of 1 results eila f lamc (Doing Business As) A 65- 0887929 Okeechobee Main St. Inc. Retum to Search Results Per Page 25 OK ly Okeechobee �I9 Le r( entry FL United States « Prev 1 -1 I Next » Prev I 1 -1 I Next » https: / /apps.irs.gov /app /eos /pub78 Search.do ?ein 1= 65- 0887929 &names = &city = &state= A11... 2/23/2017 Okeechobee County Property Appraiser Parcel: « 3-15-37-35-0010-01680-0090 » Owner & Property Info MURRAY SHANNON BRIAN Owner 10770 SE JUPITER NARROWS DR HOBE SOUND, FL 334553260 Site 210 SW 2ND ST, OKEECHOBEE CITY OF OKEECHOBEE (PLAT BOOK 1 PAGE Description 5) � BLOCK 168 �� .■ , �r _ - li i !IV w `!_�� Page lof2 2016 Tax Roll Year updated: 3/9/2017 Aerial Viewe Pictometery ovoglemaps • 2015 2014 2011 2009 2005 Sales SW PARK SI Area 0.325 AC S/T/R / -- -,K ` STORES/1 m ~ ` ` = ,,- ' �-- """^""" - - "'—=— ^ |^" °" L (001100) � �`m The Descri�tion above is not to be used as the Legal Description fo , this parcel in any legal transaction. : • 'it ) The Use Code isa Dept. of Revenue (DOR) code Please contact the :� |ox000xouooCoumvP�nn/rwmoovewpmnn nm��oox�oo�wm �f ' � ' ' }xxopoonmzvmn information Property & Assessment Values 2015 Certified Values 2016 Certified Values Mkt Land (1) $35,670 $35,670 Ag Land «» -4 $0 -[ — Ag Land (m -T-- $0 —L- XF0Bm $1/614 XF08n> $1,614 Just | s37,284 Just $37,284 Class $0 Class $0 Appraised $37,284 Appraised $37,284 Exempt $0 Exempt $0 Assessed �37.204 Assessed $37,284 """^w:$37.284 county:$37,284 Total cuv:$37.284 Total city:$37,284 Taxable other:$37,284 Taxable other:$37,284 Sales History Sale Date Sale Price —�� 9/28/2015 3/2/2015 7/1/1975 $20,000 SW 21:40 ST Sw 3RD Sw/ v. Book/Page 765/1636 757/0623 ^. AC- Deed V/I Quality (Codes) WD | U WD 173/0249 WD din Characteristics Bldg Sketch | Bldg Item | Bldg Desc Year Bit NONE O SF Actual S i ------- Base Ao�a SF { Bldg Value Extra Features & Out Buildings Code Desc Year Value Units Dims Cond�on��Good) T-- Land Breakdown Land Code Desc Eff LandVa Units Adjustments Value 3/10/2017 Jackie Dunham From: Jackie Dunham Sent: Friday, March 10, 2017 2:12 PM To: smurray @murrayinsuranceservices.com Cc: Brittany Carner Subject: Re upcoming Grand Re- opening event Attachments: Tent -Fire Extinguisher Guidelines.pdf Mr. Murray, I am just now getting a chance to review the site plan which accompanied your application. I notice you are showing a 20x30 tent. I am attaching the Tent /Fire Extinguisher guidelines that our Fire Chief provides for tents larger than 10x10. I need a copy of the Certificate of Flame resistance which should be provided by the vendor you are leasing the tent from. I am also having difficulty reading your site plan. You have the Promotions Table and a Food "???7. Can't make out that word. If you have any questions regarding the tent I would suggest to talk to the Fire Department and you can reach someone there at 863 -467- 1586. Thank you for your assistance with this. Jackie, D uNv Advni ' tra vvei Secretary City of Okeechobee/ 55 SE 7-1u;rdiAvevu Oke,e,c,hab-oe/, EL 34974 rem' 863-763-3372 eect: 217 Fay' 863-763-/686 jdunham cr,citvofokeechobee.com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1 Jackie Dunham From: Sent: To: Cc: Subject: Jackie Dunham Friday, March 17, 2017 10:31 AM Patty Burnette; Marcos Montes De Oca; Bobbie Robin Brock; City -John Cook 2nd (jrcook1648 @yahoo.com); Lane Gamiotea Certificate of Insurance Requirements Today Attorney Cook met with Bobbie and I regarding clarification of the requirements for COI's for Temporary Use Permits. Attorney Cook explained when events are held on private commercial properties such as the Brahman Theater or Royal's Plaza, we only need the individual sponsoring the event to provide the City with the COI in the amount of $1,000,000.00. We do not ask for proof of insurance for the property owner but if they would like to provide it that's fine. We do need written notarized permission from the property owner. In the case of the circus event, Attorney Cook advised to get both the COI from the sponsor as well as from the property owner. In situations when we ask for the City and /or the Hamrick Trust to be listed as "additional insured ", we must also receive a copy of the Endorsement page of the policy to be attached with the COI. Jack ie, Dw'thc m' A d mi.4u -ra-t"we'Secretary City of 0iceeato-/yee/ 55 SE TY i d✓Avev e' Okee- cholree', EL 34974 Telex' 863 -763 -3372 e4t 217 row,: 863-763-1686 jdunham(c),cityofokeechobee.com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure.