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Fee Waiver Application Summary Sheet - Revised 1/22/2024 For January 22, 2024 Board of Health Meeting Fee Waiver BOS Summary Sheet Submitted to Finance on February 1, 2024 Permits P1-Jan-24 Christ Evangelical Lutheran Church Christ Evangelical Lutheran Church $ 260.00 918 S. Litchfield Rd., Goodyear, AZ 85338 FD-45732 Food Bank P1-Jan-24 Total $ 260.00 P2-Jan-24 Benevilla Mary's Place $ 230.00 14601 N. Del Webb Blvd., Sun City, AZ 85351 FD-07566 Service Kitchen P2-Jan-24 Total $ 230.00 P3-Jan-24 First Evangelical Lutheran First Evangelical Lutheran $ 260.00 142 N. Date, Mesa, AZ 85201 FD-13389 Food Bank P3-Jan-24 Total $ 260.00 P4-Jan-24 Local First Arizona Foundation Local First Arizona Foundation $ 695.00 401 E. Roosevelt St., Phoenix, AZ 85004 FD-23-01166 E & D 0-9 Seating P4-Jan-24 Total $ 695.00 P5-Jan-24 Boys and Girls Clubs of the Valley Boys & Girls Club of East Valley $ 315.00 4309 E. Belleview St. Bldg 14, Phoenix, AZ 85008 FD-15121 E & D 10+ Seating Boys and Girls Clubs of the Valley Boys and Girls Club $ 230.00 4309 E. Belleview St. Bldg 14, Phoenix, AZ 85008 FD-15404 Service Kitchen Boys and 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 P5-Jan-24 Total $ 860.00 P6-Jan-24 Unlimited Potential Inc Unlimited Potential Inc $ 260.00 3146 E. Wier Ave., Phoenix, AZ 85040 FD-80777 Food Processor P6-Jan-24 Total $ 260.00 P7-Jan-24 Alcoholism & Addiction Assistance Assoc Hope House $ 760.00 4430 N. 23rd Ave., Phoenix, AZ 85015 FD-41047 Boarding Home P7-Jan-24 Total $ 760.00 P8-Jan-24 Society of St Vincent de Paul Our Lady of Mount Carmel Conference $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-18211 Food Jobber Society of St Vincent de Paul St Louis the King Conference $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-18225 Food Jobber Society of St Vincent de Paul St. Joan of Arc $ 255.00 PO Box 13600, Phoenix, AZ 85002-3600 FD-13822 Food Jobber P8-Jan-24 Total $ 765.00 P9-Jan-24 A New Leaf East Valley Mens Center $ 760.00 868 E. University Dr., Mesa, AZ 85203 FD-34435 Boarding Home A New Leaf Faith House Shelter $ 760.00 868 E. University Dr., Mesa, AZ 85203 FD-33086 Boarding Home P9-Jan-24 Total $ 1,520.00 P10-Jan-24 St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0691 Mobile Food St Mary's Food Bank Alliance St Mary's Food Bank $ 120.00 3003 W. Thomas Rd., Phoenix, AZ 85009 MF-17-0688 Mobile Food P10-Jan-24 Total $ 240.00 P11-Jan-24 Saguaro Janes Corporation Saguaro Janes Corporation $ 315.00 21802 W. Wilson Rd., Wittmann, AZ 85361 FD-07377 E & D 10+ Seating P11-Jan-24 Total $ 315.00 P12-Jan-24 Under God Ministries Under God Ministries $ 260.00 702 E Broadway Rd., Phoenix, AZ 85040 FD-52433 Food Bank P12-Jan-24 Total $ 260.00 Total Permits $ 6,425.00 Food Employee Training Classes Item # Administrative Name Business Requested fee Administrative Address Certificate Type Date Used C1-Jan-24 Tempe Unified School District ESS Program - Success University $260.00 500 W Guadalupe Rd., Tempe, AZ 85283-3599 Culinary 11/8/2023 C1 Total-Jan-24 $260.00 C2-Jan-24 Marching Dragons Booster Club Marching Dragons Booster Club $260.00 10541 W. Almeria Rd., Avondale, AZ 85392 Volunteers C2 Total-Jan-24 $260.00 Total Classes $520.00 Grand Total $ 6,945.00 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 1 of 1