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Temp. Use Permit - BBQ Fundraiser Chobee WrestlingCity of Okeechobee 55 S.E. 3rd Avenue Okeechobee, Florida 34974 (863) 763-9821 Temporary Use Permit Permit Number: 18-003 Permit Expiration: May 11, 2018 11:59PM Date(s) of Event: May 11, 2018 6:30AM — 2:OOPM Purpose of Request: Barbegue Fundraiser Chobee Wrestling Property Owner: Karla Roby & Debra Sales Address: 1906 SW 5th Avenue City: Okeechobee State: Florida Zip Code: 34974 Applicant: His Church -It's Jesus Church Applicant's Address: 1167 Linda Rd., Okeechobee Phone Number: 863-357-6500 Address of Project: 1600 S Parrott Ave Current Zoning: Heavy Commercial (CHV) FLU Designation: Commercial (C) Subdivision: 1St Addition S Okeeechobee Lots 1-12 & alley Block 29 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. Date: Applicant's Signature Dwaham Date: May 3, 2018 Administrative Secretary REF:.ORD.716, Temporary Structures Revised 115!18 jd --._ TEMPORARY USE PERMIT APPLICATION OTHER TEMPORARY STRUCTURES (666) City of Okeechobee - General Services Department 55 SE 3rd Ave, Room 101, City Hall, Okeechobee, FL 34974 Phone: (863) 763-3372 ext. 9821 DATE RECEIVED: _} - _ DATE ISSUED: APPLICATION NO.: EVENT DATE(S) & TIME: FEE: $175.00 [Don-Profit/Civic Organization DATE PAID: /4'4 me of Property Owner(s): C> �� �{ Ctdress:lephone Numbers: Home: Work: Cell: me of Applicant: kS Ck Lk Y -C J I/dress: l � (:�K ck, CY; _ec °0 %,�lephone Numbers: CUr Cyt 3 57 (O'S CC CAIf � tf 5 TC Home: WeFk- Cell: Future Land Use Map Desi ation: C Current Zoning Designation: t 4A v Legal Description of Property: C PCCA 6 t VIOn �� �jp (-c( t -) OL -e -c' Lo S 1— K Z CJ Address of Property: k-000 er. Ucr AIS l(). Kf eC tb -e- -e 4T7SL Please Explain Type of Use: � b be U�( S� l t Z ` t—� C\Rt �n ( -C' Se. Briefly describe use of adjoining property North: t kl SC' f-�1z East: South: C m 1 " 2-2 C West: Other temporary structures subject to the following regulations: 1. Christmas tree, fireworks and similar seasonal sales operated by a non-profit organizaiton. 2. Carnival, circus, fair or other special event operated by a non-profit organization on or abutting their principal use. ('additional information required) 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. Have notarized written permission of property owner, if applicant is not the property owner. 3. Remove all debris within 48 hours of expiration of permit. 4. Submit Site Plan, State Inspection Certificates and submit State Annual Permit City Staff Please review the application, attach comments orspecial conditions). Occupational and.or State License Verification: ° '? Lk Date: 9 Fire Department Approval: r Date: j Police Department Approval: Date: Public Works Department A val: �- — �— DaW. - 3a' Building Inspector Approval: • 2 • % D e: C City Administrator Approval: -- Date 7 I hereby certify that the information on this applicatio 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 punishab y a fine of up to $500.00 and imprisonment of up to thirty days and may result in the summary denial of this application. Signature of Applicant Date Jackie Dunham From: Jackie Dunham Sent: Wednesday, April 25, 2018 3:28 PM To: Chief Herb Smith - City of Okeechobee (Chief Herb Smith); Chief Peterson; David Allen (dallen@cityofokeechobee.com); Jeffery C. Newell 0newel I@cityofokeechobee.com); Kay Chapman (kchapman@cityofokeechobee.com); Kim Barnes (Kim Barnes); Lalo Rodriguez (Irod riguez@cityofokeechobee.com) Cc: Patty Burnette Subject: Upcoming Chobee Wrestling BBQ Fundraiser I am in receipt of a new request for a temporary use permit. The event will be held on May 11th at the Brahman Theater parking lot. Please stop by my desk to review and approve. Thank you. Jackie Du,vtha4m Ad*nLrtis&aLve-Secreta ry CLty of 0keecholxew, 55 SE M4irdlAvevuie. Okeechobee, FL 34974 863-763-3372 (Maivv) 863-763-9821 (l +,ect) 863-763-1686 (Fax) j dunhamgcityofokeechobee. com Website: http://www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. HISCH-2 OP ID: ME CERTIFICATE OF LIABILITY INSURANCE FD TE OF INSURANCE ADDL UBR T POLICY EFF POLICY NUMBER MM/DD/YYYY 03/06/2200YYYY) 03/06/ 18 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. CONTACT Lowell H Pritchard PHONE (CN FAX, -76-56291802 A/ . ExtI; 863-763-7711 a/cNo :_633 S Parrott Ave Okeechobee, FL 34974-6179 Lowell H Pritchard ADDRESS: --- ----- -- - -- - ---------------� - ------ ----- INSURERS AFFORDING COVERAGE NAIC 8 ANY AUTO ALL OWNED f SCHEDULED 'AUTOS AUTOS INSURER A: First Nat'l Ins Co of America 24724 � INSURED His Church -Its Jesus Church INSURER B: Inc.aka Buckhead Ridge 1167 Linda Road INSURER -- Okeechobee, FL 34974 INSURER D: _ INSURER E: UMBRELLA LIAB r OCCUR EXCESS LIAB CLAIMS -MADE _ - � INSURER F: COVERAGES CERTIFICATE NLIMRFR- PPX1IclnKI KII IruIRCG. 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. INSRTYPE LTR OF INSURANCE ADDL UBR T POLICY EFF POLICY NUMBER MM/DD/YYYY T POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FIOCCUR 01CI81015430 06/26/2017 06/26/2018 EACH OCCURRENCE $ 11000,00 PD AGE MISES RENTEU REoccurrence)$ 1,000,000 MED EXP (Any one person) $ 10,00 AUTHORIZED REPRESENTATIVE PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: IGENERAL PRO - j POLICY ECT LOC OTHER AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG i $ _ —2,000,00 $ AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ (Ea accidenU BODILY INJURY (Per person) $ ANY AUTO ALL OWNED f SCHEDULED 'AUTOS AUTOS � BODILY INJURY Per accident $ ( ), NON -OWNED HIRED AUTOS AUTOS __ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB r OCCUR EXCESS LIAB CLAIMS -MADE _ - � EACH OCCURRENCE Is AGGREGATE $ DED RETENTION$ $ !,WORKERS COMPENSATION AND AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F NIA PER - STATUTE ER _ E.L. EACH ACCIDENT $ (Mandatory in NH) if yes, describe under E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ q Property Section 01C181015430 06/26/2017 06/26/2018 A Equipment Floate 01CI81015430 06/26/2017 06/26/2018 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCFI I ATInN CITY -92 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci Of Okeechobee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE 3rd Ave Okeechobee, FL 34974 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date: V t V e, ' HIS CHURCH - ITS JESUS CHURCH INC 1167 LINDA RD OKEECHOBEE, FL 34974 Dear Applicant: DEPARTMENT OF THE TREASURY Employer Identification Number: 47-0978467 DLN: 17053253309014 Contact Person: DAVID A DOEKER ID# 31168 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 170 (b) (1) (A) (i) Form 990 Required: No Effective Date of Exemption: June 3, 2014 Contribution Deductibility: Yes Addendum Applies: No we are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter 114221 -PC^ in the search bar to view Publication 4221 -PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements. Letter 947 -2 - HIS CHURCH - ITS JESUS CHURCH INC We have sent a copy of this letter to your representative as indicated in your power of attorney. Sincerely, Director, Exempt Organizations Letter 947 BRAHMAN THEATER III P.O. Box 1395 Okeechobee, Florida 34973 We give permission to _Okeechobee High School Wrestling Team, to hold a fundraiser on ( (i Our property located at 1'590 S. Parrot Avenue, on _May 11 , 2018. Said party is responsible for all trash removal for stated event. ffI C'9=91 410 Debra S. Sales Owner X Karla H. Roby Owner � •_ s', d ',f � .J` L; fes. � � 4+} i' '• L�'�< ,,•.�w "(K �'}\� � fl �� i , � y P4, fo � : yr xs 7..- v-e �',a,�'rG � , �' � ' � � ;•1 •r - x � ` q -.L � J • � -' �c� }..-� i� � W�� I � ��` 'a i.. �ftl I...f`Yfs ;�� f �x.. r AM i aY.•� �. L •�N F, s � � 1�1, � ma � n ttr �, r ' 9r 31 is tAsa � '_'f3���,,tt 'w' e '.•r re �t'' �j eLr .��.� - �' �' ��`��'°' .� X � _ y _ _ P �� yy. Kf :. '• 1�:,., 'ash -`L I _ I. � rqy S r' l: • I -✓, B,'. P"� T'�'�.'y�.u__ ..�=Yt' .. � 1 Wyk � � �41 011 ry ^'k�; �•'..i` � ! S� �,. �r Y it w * 4 g7 yr � <`�,.-` 'L...s � � � an. ��, �, 4 �: ,L��� } �-�` cr+ r sy." r `• � �'.` ti }SoT � 4 w Ft �dti � � _i@i`� +`f. 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G i Ca_ 4 f j Okeechobee County Property Appraiser Mickey I, l Parcel « 3-28-37-35-0050-00290-0010 » Owner & Property Info Result: 1 of 1 Property & Assessment Values - MUD I r\ARLA not aALCa UComA o Owner 1906 SW 5TH AVE Mkt Land (2) OKEECHOBEE, FL 34974 Site 1600 S PARROTT AVE, OKEECHOBEE Ag Land ioi FIRST ADDITION TO SOUTH OKEECHOBEE Description' (PLAT BOOK 1 PAGE 17) LOTS 1 TO 12 INC & Building (1) ALLEY BLOCK 29 Area 2.066 AC SMR 28-37-35 Use Code** THEATER/AU Tax District 50 Just (003200) Class $0 *The Description above is not to be used as the Legal Description for this parcel in any legal transaction. The Use Code is a Dept. of Revenue code. Please contact Okeechobee County Planning & Development at 863-763-5548 for zoning info. Property & Assessment Values O U O 2016 Certified Values 2017 Certified Values Mkt Land (2) $381,810 Mkt Land (2) S389,82 Ag Land ioi $0 Ag Land (o) $ Building (1) $244,506 Building (1) $251,84 XFOB (8) $79,432 XFOB (8) $85,37 Just $705,748 Just $727,03 Class $0 Class $ Appraised $705,748 Appraised $727,03 Exempt $0 Exempt $ Assessed $705,748 Assessed $727,03 Q coup ty:$705,748 5/1/1972; county:$727,03 Total city:$705,748 Total city:$727,03 Taxable other:$705,748 Taxable other:$727,03 school:$705,748 school:$727,03 Sales History Page 1 of 2 2017 Tax Roll Year updated: 2/16/2018 Aerial Viewer Pictometery Google Maps O U O O O G�----7,1, 2017 2015 2014 2011 2009 2005 Sales' Quality (Godes) U r,L� 4/1/1990 �~ - 316/1278 QC I U �a_ x 7/1/1987 $0 288/1302 Pl SW 1 S T Ham. f_ai� Y ' � �i � �` 03 ' `• y s , Sw1httt,st 1> �LL�> 1 jja m 441 I "—'. 4w 17TH I YY M,1 w. us Itti t11 `^ Odle vale 10/24/2012 Sale Price $100 Book/Page 721/0733 Deed QC V/1 I I Quality (Godes) U RCode 11 4/1/1990 $0 316/1278 QC I U 03 7/1/1987 $0 288/1302 WD V U 03 1/7/1986 $0 280/0925 V U 03 1/1/1973 $0 145/0341 WD V U 03 1/1/1973 $57,5001144/0045 WD I Q 5/1/1972; $01 138/0537 WD V U 03 Building Characteristics Bldg Sketch Bldg Item Bldg Desc Year BIt Base SF Actual SF Bldg Value Sketch 1 AUDITORIUM (006000) 1974 12081 14208 $251,841 *Bldg Des c determinations are used by the Property Appraisers office solely for the purpose of determining a property's Just Value for ad valorem tax purposes and should not be used for any other purpose. rExtra Features & Out Buildings (Codes ) http://ap2.okeechobeepa.com/gis/recordSearch-3—Details/ 2/21/2018 CHOBEE WRESTLING PRESENTS 2nd Annual 0 BBQ Fundraiser Friday - May 11, 2018 11 AM - 1 P $10 Dinner Includes: Pulled Pork, Baked Beans, Potato Salad, Roll, Cookie Delivery for 3 or more Tickets available at Serenity Coffee Shop 863-824-2287