01-25-21 BOH SUMMARY FOR APPROVED PERMITS REVISED.XLSX
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Fee Waiver Application Summary Sheet For January 25, 2021 Board of Health Meeting Paid Item # Administrative Name Business Requested Fee Administrative Address Permit # Permit Type Class Y/N Note Waiver Approved (Approved/Denied) P1 Trinity Lutheran Church Trinity Lutheran Church & School $ 230.00 830 Plaza Cir., Litchfield Park, AZ 85340 FD-14274 Service Kitchen 2 N Approved P1 Total $ 230.00 P2 Society of St Vincent de Paul St Agnes Conference $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-18227 Food Jobber 2 N Approved Society of St Vincent de Paul St Louis The King Conference $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-18225 Food Jobber 2 N Approved Society of St Vincent de Paul Society of St Vincent de Paul $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-13821 Food Jobber 2 N Approved Society of St Vincent de Paul Society of St Vincent de Paul $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-13822 Food Jobber 2 N Approved P2 Total $ 1,020.00 P3 St John Institutional Baptist Church Inc St John Institutional Baptist Church $ 650.00 1428 S. 13th Ave., Phoenix, AZ 85007 FD-38379 E & D 10+ Seating 3 N Approved P3 Total $ 655.00 P4 A New Leaf East Valley Mens Club $ 760.00 868 E. University Dr., Mesa, AZ 85203 FD-34435 Boarding Home 5 N Approved P4 Total $ 760.00 P5 Phoenix Rescue Mission Mission Possible AZ $ 310.00 1516 W. Van Buren St., Phoenix, AZ 85007 FD-47484 Bakery 2 N Approved Phoenix Rescue Mission Mission Possible AZ $ 695.00 1516 W. Van Buren St., Phoenix, AZ 85007 FD-47352 E & D 0 - 9 Seating 4 N Approved Phoenix Gospel Mission Hope for Hunger $ 260.00 1540 W. Van Buren St.,Phoenix, AZ 85007 FD-62201 Food Bank 2 N Approved P5 Total $ 1,265.00 P6 Mercy Ministries Mercy Ministries $ 260.00 745 W. Fillmore St., Phoenix, AZ 85007 FD-45996 Food Bank 2 N Approved P6 Total $ 260.00 Paid $325 on P7 Amadeo Vineyard Church 3rd Place Cup/Amadeo Vineyard Church $ 650.00 21805 S. Ellsworth Rd., Queen creek, AZ 85142 FD-32217 E & D 10+ Seating 3 N 11/16/20 Approved P7 Total $ 650.00 P8 The Joy Bus Inc The Joy Bus Diner $ 1,030.00 3375 E. Shea Blvd. Ste #C1, Phoenix, AZ 85028 FD-48148 E & D 10+ Seating 4 N Approved P8 Total $ 1,030.00 P9 Desert Mission Inc HonorHealth Desert Mission Food Bank $ 455.00 9225 N. 3rd St. Ste #200, Phoenix, AZ 85020 FD-60183 E & D 0 - 9 Seating 3 N Approved P9 Total $ 455.00 P10 Boys & Girls Clubs of the Valley Boys and Girls Club $ 230.00 4309 E. Belleview St. Bldg. #14, Phoenix, AZ 85008 FD-15404 Service Kitchen 2 N Approved Boys & Girls Clubs of the Valley Boys & Girls Club Metro Phoenix $ 315.00 4309 E. Belleview St. Bldg. #14, Phoenix, AZ 85008 FD-13640 E & D 10+ Seating 2 N Approved Boys & Girls Clubs of the Valley Mesa Arts Academy $ 185.00 2602 W. Baseline Rd. Suite 25, Mesa, AZ 85202 NF-00370 School Grounds Y Approved Boys & Girls Clubs of the Valley Boys & Girls Club of East Valley $ 315.00 2602 W. Baseline Rd. Suite 25, Mesa, AZ 85202 FD-15121 E & D 10+ Seating 2 N Approved P10 Total $ 1,045.00 P11 New Life Center New Life Center $ 760.00 PO Box 5005, Goodyear, AZ 85338 FD-41281 Boarding Home 5 Y Approved P11 Total $ 760.00 P12 Central Arizona Shelter Services Central Arizona Shelter Services $ 275.00 230 S. 12th Ave., Phoenix, AZ 85007 FD-09793 Boarding Home 2 N Approved P12 Total $ 275.00 P13 Tiger Mountain Foundation Tiger Mountain Foundation $ 260.00 3146 E. Wier Ave., Suite 31, Phoenix, AZ 85040 FD-80499 Food Processor 2 N Approved Tiger Mountain Foundation Tiger Mountain Foundation $ 650.00 3146 E. Wier Ave., Suite 31, Phoenix, AZ 85040 FD-80765 E & D 10+ Seating 3 N Approved P13 Total $ 910.00 P14 Unlimited Potential Inc. Unlimited Potential $ 260.00 3146 E. Wier Ave., Phoenix, AZ 85040 FD-80777 Food Processor 2 N Approved P14 Total $ 260.00 P15 Alcoholism & Addiction Assistance Assoc Hope House $ 760.00 4430 N. 23rd Ave., Phoenix, AZ 85015 FD-41047 Boarding Home 5 N Approved P15 Total $ 760.00 P16 Benevilla Mary's Place $ 230.00 14601 N. Del Webb Blvd., Sun City, AZ 85351 FD-07566 Service Kitchen 2 N Approved P16 Total $ 230.00 P17 Tempe Community Action Agency Tempe Community Action Agency $ 260.00 2146 E. Apached Blvd., Tempe, AZ 85281 FD-56052 Food Bank 2 Y Approved P17 Total $ 260.00 P18 First Evangelical Lutheran Church First Evangelical Lutheran $ 260.00 142 N. Date, Mesa, Az 85201 FD-13389 Food Bank 2 N Approved P18 Total $ 260.00 P19 House of Refuge Sunnyslope House of Refuge Sunnyslope $ 760.00 9844 N. 7th Pl., Phoenix, AZ 85020-1701 FD-03573 Boarding Home 5 N Approved P19 Total $ 760.00 P20 St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 2831 N. 31st Ave., Phoenix, AZ 85335 MF-18-0607 Food Peddler 2 N Approved St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0688 Food Peddler 2 N Approved St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0691 Food Peddler 2 N Approved St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0690 Food Peddler 2 N Approved St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0689 Food Peddler 2 N Approved St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0685 Food Peddler 2 N Approved P20 Total $ 720.00 P21 Teen Challenge of Arizona Teen Challenge $ 760.00 1515 NW Grand Ave., Phoenix, AZ 85007 FD-03018 Boarding Home 5 N Approved P21 Total $ 760.00 Total Permits $ 13,325.00 Grand Total $ 13,325.00 Page 1 of 7 Requested Item # Administrative Name Business fee # of Classes Administrative Address Requested Certificate Type Gone to Date to Waiver Approved (Approved/Denied) Fee Used # Used Date Used BOS (Y/N) BOS Fee Wavier Summary Sheet for January 25, 2021 BOH meeting Item # Administrative Name Business Requested Fee Fee Wavier Summary Sheet for January 25, 2021 BOH meeting Administrative Address Permit # Permit Type Class Waiver Approved (Approved/Denied) Fee Wavier Summary Sheet for January 25, 2021 BOH meeting Previous Paid (Yes/No)