HomeMy WebLinkAbout2845 CROSSROADS BLVD (2) -��'� INVOICE DATE DUE DATE INVOICE# TOTAL DUE
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1�'su,, 02/14/2018 03/20/2018 2018-00000178 $80.00r`�
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Customer#: 20755 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
PANCI ERO'S MEXICAN GRILL 715 Mulberry St
2845 CROSSROADS 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-2845 CROSSROADS BLVD-2-9-18 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
20755 02/14/2018 03/20/2018 2018-00000178 $80.00
Less Prepayment $0.00
Total Due $80.00
City of Waterloo
C imntrcial Fire Inspection Report
Inspection Number 1268
Prior Inspection 255
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* 2845 Crossroads Boulevard
Business name Pancheros Mexican Grill
Inspection Date* 2/9/2018
Proprietor Adam Langner
Business Phone 319-232-5081
Email* Pmg72@pancheres.com
Email 2
Property Owner Corp
Emergency Contact Adam Langner
Information
Phone
Violations
Ref# CODE Violation &Location Corrected
1
Comments: No violations noted at this time.
Oily waste receptacle on site.
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 Semi-Annual Kitchen hood Cleaning for all Hoods
Comment Cody's 1/14/18
Reports Semi-Annual Kitchen hood Fire Suppression for all Hoods
Comment Superior 1/30/18
Reports Fire Extinguisher Service
Comment Superior 1/30/18
Inspection Fee $ 70.00
Occupancy Fee $ 10.00
Re-inspection Fee $
Total Fee* $ 80.00
Received By Adam Langner
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
Reinspection
Re-inspection# Date Time