Loading...
HomeMy WebLinkAbout315 PARK RD - � INVOICE DATE• DUE DATE INVOICE# TOTAL DUE i�/�!1\\,,, \I 1Rir r,. 04/12/2018 05/30/2018 2018-00000291 $80.00 P? it. r Customer#: 4437 Please Make Check Payable and Remit To: City of Waterloo ATTN: City Clerk Accounts Receivable HICKORY HOUSE 715 Mulberry St 315 PARK RD WATERLOO, IA 50703 WATERLOO,IA 50703 Amount Enclosed: DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT KEEP THIS PORTION FOR YOUR RECORDS COMMERCIAL INSPECTION-315 PARK RD-4-17-18 FOR BILLING INQUIRY: (319)291-4323 L Description Total Price INSPECTION 2,000 $70.00 OCCUPANCY FEE $10.00 CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES 4437 04/12/2018 05/30/2018 2018-00000291 $80.00 Less Prepayment $0.00 Total Due $80.00 City of Waterloo Commercial Fire Inspection Report r-, Inspection Number 1398 Prior Inspection 332 Number Fill this field if it is available, it will auto-fill business name and address. Inspector* Jeff Siebel Waterloo Fire Rescue 715 Mulberry Street Waterloo, IA 50703 Phone(319)-230-1224 Fax. (319)-291-4262 Email:Jeff.Siebel©waterloo-ia.org File Upload Address* 315 Park Road Business name Hickory House Inspection Date* 4/17/2018 Proprietor Tim Chilcote Business Phone 319-233-9111 Email* Cindy.Young@Waterloo-ia.org Email 2 Property Owner Tim Chilcote Emergency Contact Tim Chilcote Information Phone 319-230-6559 Violations Ref# CODE Violation &Location Corrected 1 609.3.3.1 Provide current semi-annual kitchen hood exhaust system cleaning/inspection report with all deficiencies corrected. 2 904.11.6. Provide current semi-annual kitchen hood fire suppression system 2 inspection/testing with all deficiencies corrected by a contractor certified to work in the State of Iowa 3 Provide annual service for fire extinguishers. Comments: If violations noted during the inspection are not corrected by the given re-inspection date, additional fees are as follows: $100.00-First Re-inspection I$150.00-Second Re-inspection I$200-Third and subsequent Re-inspections Reports Reports Comment Inspection Fee $ 70.00 Occupancy Fee $ 10.00 Re-inspection Fee $ Total Fee' $ 80.00 Received By Tim Chilcote AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM. File Upload(for long inspections) Reinspection Re-inspection# Date Time 1 5/8/2018