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Fee Waiver BOS Summary Sheet Submitted to Finance on 10/28/15 Item # Administrative Name Business Requested Fee Administrative Address Permit # Permit Type Class Waiver Approved (Approved/Denied) Previous Paid (Yes/No) P1-Oct-15 Society of St Vincent de Paul Our Lady of Mount Carmel Conference $ 255.00 P.O Box 13600 Phoenix, AZ 85002 FD-18211 Food Jobber 2 Approved Society of St Vincent de Paul St Anthony of Podua $ 255.00 P.O Box 13600 Phoenix, AZ 85002 FD-14956 Food Jobber 2 Approved Society of St Vincent de Paul St Daniel the Prophet Conference $ 255.00 P.O Box 13600 Phoenix, AZ 85002 FD-18231 Food Jobber 2 Approved Society of St Vincent de Paul Holy Family Conference $ 255.00 P.O Box 13600 Phoenix, AZ 85002 FD-18221 Food Jobber 2 Approved Society of St Vincent de Paul St Agnus Conference $ 255.00 P.O Box 13600 Phoenix, AZ 85002 FD-18227 Food Jobber 2 Approved Society of St Vincent de Paul St Louis the King Conference $ 255.00 P.O Box 13600 Phoenix, AZ 85002 FD-18225 Food Jobber 2 Approved P1-Oct-15 Total $ 1,530.00 P2-Oct-15 Peoria Unified School District Ironwood Marketing Store $ 235.00 6330 W. Thunderbird Rd., Glendale, AZ 85306 FD-29208 Retail Food 2 Approved Peoria Unified School District Raymond S Kellis High School Culinary Arts $ 1,030.00 8990 W Orange Ave., Glendale, AZ 85305 FD-29246 E&D 10+ Seating 4 Approved Peoria Unified School District Cactus High School Culinary Arts $ 1,030.00 6330 W. Greenway Rd., Glendale, AZ 85306 FD-29234 E&D 10+ Seating 4 Approved Peoria Unified School District Centennial High School Culinary Arts $ 1,030.00 14388 N. 79th Ave., Peoria, AZ 85381 FD-29239 E&D 10+ Seating 4 Approved P2-Oct-15 Total $ 3,325.00 P3-Oct-15 Trinity Baptist Church Trinity Baptist Church $ 1,030.00 2130 E. University Drive, Mesa, AZ 85213 FD-11584 E&D 10+ Seating 4 Approved P3-Oct-15 Total $ 1,030.00 P4-Oct-15 Saguaro Janes's Corp Wittmann Community Center $ 315.00 PO Box 151, Wittmann, AZ 85361 FD-07377 E&D 10+ Seating 2 Approved P4-Oct-15 Total $ 315.00 P5-Oct-15 All Faith Community Services All Faith Community Services $ 315.00 214 S. 5th Street, Buckeye, AZ 85326 FD-45641 Plan Review All Faith Community Services All Faith Community Services $ 455.00 214 S. 5th Street, Buckeye, AZ 85326 FD-45641 E&D 0-9 Seating 3 Approved P5-Oct-15 Total $ 770.00 Roosevelt Row Community Development Special Event- Chile Pepper Festival, P6-Oct-15 Corporation September 26th and 27th $ 85.00 922 N. 5th Street, Phoenix, AZ 85004 FD-45829 Temporary Approved P6-Oct-15 Total $ 85.00 THE CHURCH ON FILLMORE OF PHOENIX, THE CHURCH ON FILLMORE OF PHOENIX, P7-Oct-15 ARIZONA ARIZONA $ 615.00 745 W. Fillmore St., Phoenix, AZ 85007 FD-45996 Plan Review Approved P7-Oct-15 Total $ 615.00 Extended Hands Food Bank/Warehouse P8-Oct-15 Ministries of Fountain Hills Warehouse Ministries of Fountain Hills $ 1,030.00 4303 E. Cactus Rd. #240, Phoenix, AZ FD-19271 E&D 10+ Seating 4 Approved P8-Oct-15 Total $ 1,030.00 Special Event- Fishin for the Cure, P9-Oct-15 Fishin' for the Cure September 19, 2015 $ 85.00 37406 N. 7th Ave., Phoenix, AZ 85086 FD-45780 Temporary Approved P9-Oct-15 Total $ 85.00 P10-Oct-15 Christ Evangelical Lutheran Church Christ Evangelical Lutheran Church $ 315.00 918 S Litchfield Rd, Goodyear, AZ FD-45732 Plan Review Approved Christ Evangelical Lutheran Church Christ Evangelical Lutheran Church $ 260.00 918 S Litchfield Rd, Goodyear, AZ FD-45732 Food Bank 2 Approved P10-Oct-15 Total $ 575.00 P11 Paragon Management Inc Paradise Honors High School $ 185.00 15533 W Paradise Lane, Surprise, AZ 85374 NF-02125 School Grounds Approved Paradise Education Center Paradise Education Center $ 650.00 15533 W Paradise Lane, Surprise, AZ 85374 FD-08298 E & D 10+ Seating 3 Approved P11 Total $ 835.00 P12-Oct-15 Community Christian Church Community Christian Church $ 650.00 1701 S College Ave, Tempe, AZ 85281 FD-16651 E & D 10+ Seating 3 Approved P12-Oct- 15 Total $ 650.00 Robert Sanders/Lutheran Social Services of P13-Oct-15 the Southwest First Evangelicai Lutheran $ 260.00 142 N. Date, Mesa, AZ 85201 FD-13389 Food Bank 2 Approved P13-Oct-15 Total $ 260.00 P14-Oct-15 Kristen Alridge One True Love $ 75.00 61 N. Spencer, Mesa, AZ 85203 MF-15-0083 Plan Review Approved Kristen Alridge One True Love $ 610.00 61 N. Spencer, Mesa, AZ 85203 MF-15-0083 Mobile Food Unit 3 Approved P14-Oct-15 Total $ 685.00 P15-Oct-15 Amadeo Church Inc Third Place Cup $ 315.00 21805 S. Ellsworth Rd., Suite #102, Queen Creek, AZ 85142 FD-32217 E & D 10+ Seating 2 Approved P15-Oct-15 Total $ 315.00 Special Event- Yard and Crafts Sale P16-Oct-15 San Tan Historical Society & Museum October 17, 2015 $ 85.00 20425 S. Old Ellsworth Road, Quenn Creek, AZ 95142 FD-46541 Temporary P16-Oct-15 Total $ 85.00 P17-Oct-15 Chandler Lions Club Foundation Chandler Lions Club Foundation $ 260.00 4500 S. Basha Rd., Chandler, AZ 85248 FD-32636 E & D 0-9 Seating 2 Approved P17-Oct-15 Total $ 260.00 P18-Oct-15 St. John Institutional Baptist Church St. John Institutional Baptist Church $ 650.00 1428 S. 13th Ave., Phoenix, AZ 85007 FD-38379 E & D 10+ Seating 3 Approved P18-Oct-15 Total $ 650.00 P19-Oct-15 S.T.A.R. Stand Together and Recover Centers S.T.A.R. Stand Together and Recover Centers $ 100.00 605 N. Central Ave., Avondale, AZ 85323 FD-26704 Adult Daycare 3 Approved P19-Oct-15 Total $ 100.00 P20-Oct-15 Devereux Scottsdale Devereux Scottsdale $ 1,010.00 6436 E. Sweatwater Ave., Scottsdale, AZ 85254 FD-40663 Hospital Food Service 5 Approved P20-Oct-15 Total $ 1,010.00 Total Permits $ 14,210.00 1-Aug-15 Lura Turner Homes Inc Civitan House $ 670.00 8640 N 19th Ave Suite #14, Phoenix, AZ 85021 FD-00212 Assisted Living 5 Approved 1-Aug-15 Total $ 670.00 Total Other Permits $ 670.00 Page 1 of 2 Gone to Item # Administrative Name Business Fee Used Administrative Address # Used Certificate Type Waiver Approved (Approved/Denied) Date Used Fin (Y/N) 23-Apr-15 Chandler Chistian Community College Chandler Chistian Community College $ 60.00 345 S. California st., Chandler, AZ 85224 6 Volunteer Approved 8/6/2015 N 23-Apr-15 Total $ 60.00 6 12-Jul-15 Mesa Public Schools Dobson High School $ 280.00 1501 W. Guadalupe Rd., Mesa, AZ 85202 28 Culinary Approved 9/22/2015 N 12-Jul-15 Mesa Public Schools Dobson High School $ 280.00 1501 W. Guadalupe Rd., Mesa, AZ 85202 28 Culinary Approved 9/22/2015 N 12-Jul-15 Mesa Public Schools Dobson High School $ 240.00 1501 W. Guadalupe Rd., Mesa, AZ 85202 24 Culinary Approved 9/23/2015 N 12-Jul-15 Mesa Public Schools Dobson High School $ 250.00 1501 W. Guadalupe Rd., Mesa, AZ 85202 25 Culinary Approved 9/23/2015 N 12-Jul-15 Mesa Public Schools Dobson High School $ 120.00 1501 W. Guadalupe Rd., Mesa, AZ 85202 12 Culinary Approved 9/24/2015 N 12-Jul-15 Mesa Public Schools Dobson High School $ 310.00 1501 W. Guadalupe Rd., Mesa, AZ 85202 31 Culinary Approved 9/24/2015 N 12-Jul-15 Total $ 1,480.00 148 27-Jul-15 Phoenix Union High School District Metro Tech High School $ 110.00 1900 W. Thomas Rd., Phoenix, AZ 85015 11 Culinary Approved 9/3/2015 N Phoenix Union High School District Metro Tech High School $ 60.00 1900 W. Thomas Rd., Phoenix, AZ 85015 6 Culinary Approved 9/3/2015 N 27-Jul-15 Total $ 170.00 17 3-Jul-15 Peoria Unified School District Cactus High School $ 210.00 6330 W. Greenway Rd., Glendale, AZ 85306 21 Culinary Approved 9/29/2015 N 3-Jul-15 Total $ 210.00 21 C3-Oct-15 Lakeview United Methodist Church Lakeview United Methodist Church $ 230.00 10298 W. Thunderbird Blvd., Sun City, AZ 85351 23 Volunteer Approved 10/27/2015 N C3-Oct-15 Total $ 230.00 23 Total Food Service Worker Certificates $ 2,150.00 Grand Total To BOS $ 17,030.00 An alphanumeric item # is used above The first digits indicate the item number as it originally appreared on the summary sheet The middle letters indicate the month of the BOH meeting The last two digits indicate the year of the BOH meeting Page 2 of 2