HomeMy WebLinkAbout2780 CROSSROADS BLVD INVOICE DATE DUE DATE INVOICE# TOTAL DUE
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1 4�■�� ,�.,, 11/17/2022 12/20/2022 2023-00010998 $200.00
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Customer#: 9993 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
APPLEBEE'S 715 Mulberry St
2780 CROSSSROADS BLVD WATERLOO, IA 50703
WATERLOO,IA 50702
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-2780 CROSSROADS BLVD- 9-28-22 FOR BILLING INQUIRY: (319)291-4323
LDescription I Total Price
REINSPECTION 3 $200.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
9993 11/17/2022 12/20/2022 2023-00010998 $200.00
Less Prepayment $0.00
Total Due—f $200.00
City of Waterloo
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WATERLOO FIRE RESCUE �pTERLOO
INSPECTION REPORT441:0,
APPLEBEE'S,2780 CROSSROADS BLVD,BLDG 2780 CROSSROADS BLVD,WATERLOO/A 50702
DETAILS
Inspection Date:09/28/2022 Inspection Type:Annual Inspection(1Yr) Inspection Number:8688 ' Shift: N/A I Station: N/A
Unit: N/A I Lead Inspector:JEFF SIEBEL Other Inspectors: N/A
STATUS CODE DESCRIPTION
FAI L 604.2.12-Means of egress Emergency power shall be provided for means of egress illumination in accordance
illumination with Sections 1008.3 and 1104.5.1.
Inspector:JEFF SIEBEL-Comments:repair egress lights:Above high chairs North
Dining area.
FAI 609.3.3.3-Records Records for inspections shall state the individual and company performing the
inspection,a description of the inspection and when the inspection took place.
Records for cleanings shall state the individual and company performing the cleaning
and when the cleaning took place.Such records shall be completed after each
inspection or cleaning and maintained.
Inspector:JEFF SIEBEL-Comments: Provide current semi-annual fire suppression
inspection report with all discrepancies corrected.Contractor must upload
corrections online to the compliance engine.Currently 175 days past due.
GENERAL NOTES
JEFF SIEBEL-09/29/2022 @ 09:07 re-inspection fee$200
REINSPECTION DATE
10/18/2022
CONTACT SIGNATURE
Terrance Williams Mgr 2022 r J
Signed on:09/29/2022 @ 09:08 C
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Printed on 09/29/2022 @ 09:10
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INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:09/29/2022 @ 09:08
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 09/29/2022 @ 09:10
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