HomeMy WebLinkAbout1215 ANSBOROUGH AVE INVOICE D4.TE DUE DATE INVOICE# TOTAL DUE
itT11F■\ritt 03/01/2018 04/05/2018 2018-00000213 $80.00
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Customer#: 6293 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
BURGER KING 715 Mulberry St
1215 ANSBOROUGH AV WATERLOO, IA 50703
WATERLOO,IA 50701
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1215 ANSBOROUGH AVE-2-20-18 FOR BILLING INQUIRY: (319)291-4323
Description Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
9.0.0C
CUSTOMER# _ BILLING DATE DUE DATE INVOICE# CHARGES
6293 03/01/2018 04/05/2018 2018-00000213 $80.00
Less Prepayment $0.00
Total Due-- $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1302
Prior Inspection Fill this field if it is available, it will auto-fill business name and address.
Number
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* 1215 Ansboruogh
Business name Burger King
Inspection Date* 2/20/2018
Proprietor Joyce Johannsen
Business Phone 319-234-6669
Email* Joyce@Rockkinglp.com
Email 2
Property Owner
Emergency Contact Joyce Johannsen
Information
Phone 319-404-2017
Violations
Ref# CODE Violation &Location Corrected
1 904.11.6. 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
2 Repair egress light by restroom hallway.
3 Remove electric heater in drive up area
4 repair egress light in men's rest room
5 repair egress light women's rest room
6 Repair exit light above back door.
Ref# CODE Violation &Location Corrected
7 Replace damaged electric cord in kitchen.
Comments: Maintain storage a minimum of 24"below ceiling throughout store.
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 Fire Extinguisher Service
Comment Proshield 1/18
Inspection Fee S 70.00
Occupancy Fee S 10.00
Re-inspection Fee $
Total Fee* $ 80.00
Received By Joyce Johannsen
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long Burger king ansbourough 2.JPG 105.59KB
inspections) Burger king ansbough.JPG 97.13KB
Reinspection
Re-inspection# Date Time
1 3/13/2018