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Temporary Use_Anita's Rental Properties_ Kentucky Derby ���0iftfo of t4.'y CITY OF OKEECHOBEE oT` 55 SE THIRD AVENUE �o o; OKEECHOBEE, FL 34974 ;_I, _ A' Tele:Tele: 863-763-9821 Fax 863-763-1686 %,;�4%,41/ e-mail: permit@cityofokeechobee.com Temporary Use Permit Permit Number: T-25-006 Date(s) of Event: May 3, 2025, 5 PM — 10 PM Permit Expiration: May 3, 2025 @ 11:59 PM Purpose of Request: Okeechobee Kentucky Derby Property Owner: Anita's Rental Properties Inc Address: 701 NE 3rd Street City: Okeechobee State: Florida Zip Code: 34972 Applicant: ANITA NUNEZ Applicant's Address: 974 Marlin Drive Jupiter, FL 33458 Phone Number: 863-634-1289 Address of Project: 1011 S Parrott Avenue Current Zoning: Heavy Commercial (CHV) FLU Designation: Commercial (C) Subdivision: Unplatted Lands of the City Restrictions/Remarks: • Contact the Okeechobee County Fire Department at 863-763-5544 to schedule a final field inspection before the event. • All debris must be removed within 24 hours of the expiration date. 7eene¢a onde April 8, 2025 General Services Administrative Secretary Date t TEMPORARY USE PERMIT APPLICATION v4. OTHER TEMPORARY STRUCTURES (666) lit City of Okeechobee -General Services Department " `„" • �� 55 SE 3rd Ave,Room 101, City Hall,Okeechobee,FL 34974 . %.... % 6 Phone:(863)763-3372 ext.9821 DATE RECEIVED: Li Ii /2 5 DATE ISSUED: 1.4 ($[25 APPLICATION NO.: "T---2.S-00 to EVENT DATE(S)&TIME: 5 - 3 .- ZS FEE:$175.00 �lon-ProfrtiCivic Organization DATE PAID: c4/1125 m- iI 0 pi ll Name of Property Owner(s): f n i l-cc i R e -l�.1.( Fibber i es. Address: y-}.— S, 1Pcc(rO- (A-ie Telephone Numbers: I 0 1 1 Home: Work: Cell: 6403 lv3( -11 a ,,s, Name of Applicant: n r 4 ,_ ��n ;1'l.(rrc'W T�)7 d Address: 9-79 /farlr n N . �t.trikt-- L -Vy.5,Y Telephone Numbers: Home: Work: Cell: �(.4,�j -- ( 3--(— I - / C�mme c c�czl Current Zoning Designation: C V Future Land Use Map Desigation: '' 11 Legal Description of Property: Oy ( ( l -8-S DC`1" -C14-4 Address of Property: I O‘( }\` - -?0,4-(,-,4 A v € Please Explain Type of Use: Spe c:1&I E-U-eM Briefly describe use of adjoining property North: fS' ec.rtAt.— East: ��`_.)-N.‘.A.6e_ -‘1; West: c-a-y\ S 'P c c c, Ut\ /Y3 - (Souih� ���c�iF�l- -�*-1 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$1,000,000.00 per occurrence. 2.Have notarized written permission of property owner,if applicant is not the property owner. 3.Remove all debris within 48 hours of expiration of permit. 4.Submit Site Plan,State Inspection Certificates and submit State Annual Permit* City Staff(Please review the 'cation,a ac mments or special conditions). / /2-6-- Business Tax Receipt Verification /`�;) - Date: Z Fire Department Approval: Date: Li Police Department Approval: Date: 4t r Z$ Public Works Department App I: Date: V Date: Lk' '2 c.S Building Inspector Approval: W.--.. /....)-__S City Administrator Appro Date: I hereby certmisleading the info atlon on this application is correct.The information I uded i— i this application a by the City of Okeechobee in proc denialesfsing this myap request.cation. False or misleading information may be punishable by a fine of up to$500.00 and imprisonment of up to thirty days and may result in the summary '/G't't/r L ' — ZS Date Revised 5-13-24 pb Signature of Applicant w d' It. (lkcechobee County Fire Rescue C,„,,,) 0 y City of Okeechobee 707 NW 6th Street 1• 55 SE 3rd Avenue Okeechobee,FL 34972 ���' Okeechobee,FL 34974 Phone(863)163-5544 ��t'' Phone(863)763-3372 ^l Tent Permit Application Permit # *Permit is not required for tents less than 900 square feet* In addition to this permit application,three copies of the following must be submitted for approval: ❑ Certificate of Flame Resistance for tent/canopy meeting the flame propagation performance criteria per NFPA 701 Standard Methods of Fire Test for Flame Propagation of Textiles and Films o Floor Plan of tent depicting layout,entrances/exits,and extinguisher locations(hand drawn plans will not be accepted). o Copy of License to sell fireworks(if applicable)Owner Owner Address o Address City City lip _ State____ ___ Zip c State Phone( ) 4 Phone(`____) E-mail 1 E-mail__ Signature - Signature Proposed Tent Description Proposed Tent Location Tent Size Address ❑Open ❑Enclosed Parcel Identification Number Safety Code,Chapter 11 High- Rise requirementsEP124 are n 7 Retail with of Conal Fire Protection nsumer Fireworks.Association h setare theNminmumlr requirements approved by the ASpecial hority Having Jurisdiction Rise Buildings,NFPA 11 ke Chapter 7 untyilire es Co (AHJ),Okeechobee County Fire Rescue.The AHJ reserves the right to exceed the minimum requirements as conditions warrant. Please initial next to$ch statement censed contractor, ave a current tag,and be readily accessible. MEANSPORTABLE IRE EXTINGUISHERS: T minimum numbber of ere extinguishers is provided t be inspected frrom the retail saley a s areas shall be not less than three(3)Means of egress, ncluding but not MEANS OF EGRESS:Theit limited to aisles,doors,and exit discharge, from tents shall have all times when the tent is occupied. opening width of not less hanx44sin ties shall not be required to be illuminated in tents that are notopen for business afterdark.Exit openings EGRESS TRAVEL DISTANCE:Exits ia�provided �bsmfieted the aof egress travel does shall be located 75 feet.that the maximum egress travel distance,measured from the most remote pointE to WIDTH:exit the c. AMERENYAisles shall Themeans tof egress,including exit discharge shall be lluminat d whenever the tent is occupied.Emergenced at all times the tent is occupied 1 lighting sha by the ll not EMERGENCY LIGHTING: required in tents that are not open for business after dusk. _ELECTRICAL:Electrical wiring to the tent'rated for s temporary exterior electrical system,the conductors shall be provided with physical.Where temporary electrical cprotecti n against damage caused by ors are placed on top of an outdoor surface connect the permanent power source pedestrian or DEPARTMENT THE TemporaryACCESS: :Anyipal ort on of thetsidewall of a tent shall be accessible with►nrational 150 feet of atric Code. publ c way or approved access by the fire _ FIRE DEPARTMENT ACCESS:Any Po pointingaway pany not be department. shall not be allowed within shall feet of tents COOKING OPERATIONS:Cooking requiring LPG must be outside of the tent ointfn from exposures.Cookingequipment oftype permitted within 20 feet of tents used for storage or sale of consumer fireworks.Open flame cooking equipment of any type used for storage or sale of consumer fireworks. SIGNS:Signage stating"NO SMOKING"in 2-inch letters on a contrasting background shall be conspicuously posted at each entrance. SECURITY:Signage stating"NO FIREWORKS DISCHARGE WITHIN 300 FEET"in 4-inch letters on a contrasting background shall be conspicuously posted (if applicable). FLAME BREAKS:Tents used he tnot bereuired for packaged shall not exceed display displayed in bins,display racks,on pallets or tables lensions of 4 feet wide,8 feet in length ocated 6 feet t the end in of Flame breaks and solid display surfaces shall9 a row of display fixtures. CLEARANCE TO COMBUSTIBLES:The area located within 30 feet of a tent used for sales of consumer fireworks shall be kept free of accumulated dry grass, dry brush,and combustible debris. shall not be located within DISTANCE FROM FUEL abovegroundDISPENSING:Tents for use of consumer fireworks storage tanks for flammable or combustible liquidsflammabl gas,or flammable 0liquified gas;compressed feet front the following:rnatual etail ae dispensing station dispensers; gas- dispensing station dispensers;motor vehicle fuel-dispensing station dispensers. DISTANCE FROM BULK FUEL DISPENSING: SoIN:Tents for e liquid,flammable ge fireworks ,flammable slhall not ed be located within 300 feet of any aboveground bulkstorage s. or bulk dispensing N : for the following:o.flammable PARKING:No motor vehicle or trailer used for the storage of consumer fireworks shall be parked within 20 feet of a tent except when delivering,loading,or unloading fireworks or other merchandise and materials used,stored,or displayed for sale. SEPARATION DISTANCES:Tents for for the storageconsumer of consumer fireworks.sales I have a Tents for use of consumer fireworks shall bee10 feet frombuilding, vehicl pdarkcombustibles, ng.bush es, other tentsS and aC y motor vehicle or:Temporaryer usedwered equipment,and electrical cords that are used in conjunction with a tent used for the SOURCES OF IGNITION: electrical equipment,battery-powered sales of consumer fireworks shall be listed and used in accordance with their listing. PORTABLE GENERATORS:Portable generators supplying power to tents for the sale of consumer fireworks shall use only Class III combustible liquid fuels. Class II and Class III combustible liquid limited t Belshall be oltrtatted to not more than 5 ble generators shall be located not ns.Portable ess than 20 generators eet frromall be the tent.Whereto se Class I gene generator fuel flammable toage is as fuel,provided the quantity of such fuel is limited gallons. located not less than 50 feet from a tent for the sale of consumer fireworks. Dvenom. A cony of the approved ermit shall be on the remises and made available to the AHJ u n r uest. DATE(MM/DD/YYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 04/01/2025 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 have ADDITIONAL INSURED provisions or 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 CONTACT Tonya Stamm NAME: Milton Carpenter Insurance,Inc. (A/CON ExtI: (561)996-7211 FAX No): (561)996-2601 135 S.E.Avenue C E-MAIL tnya@mcarpenterins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Belle Glade FL 33430 INSURER A: Southern-Owners Insurance Company 10190 INSURED INSURER B Anita's Enterprises Inc INSURER C: 701 Ne 3Rd St INSURER D: INSURER E Okeechobee FL 34972-4576 INSURER F: COVERAGES CERTIFICATE NUMBER: 25-26 Master COI 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A 72072364 01/04/2025 01/04/2026 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY [ 1 JECT 'ECr ( I LOC PRODUCTS-COMP/OPAGG $ 2,000,000 ES 1 OTHER: Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE n NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability for Parrott Island Restaurant CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Okeechobee ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE Third Avenue AUTHORIZED REPRESENTATIVE Okeechobee FL 34974 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD PcLrro+4 -\ahc Dccv 1Q.J'ILI e_ , ---Pacy- V ( o\ 61 9.._.-c- el.__ id Aker td be_sr, U e hdo r y ..... p .< lo l en-h' VI -10-G,1 cis c i zD i 1 7 1 (e'ye -To-b(c NI X V1 ' .y Sand c.:.� ,j c 1 S"`�S S fa 1E1ec± I ic(