HomeMy WebLinkAbout1130 ANSBOROUGH AVE INVOICE DATE DUE DATE INVOICE# TOTAL DUE
/1 ,�■R ,�.;1`2; 06/20/2018 07/20/2018 2018-00000401 $100.00
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Customer#: 5760 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
PIZZA HUT 715 Mulberry St
720 W 20TH ST WATERLOO, IA 50703
PITTSBURG,KS 66762
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1130 ANSBOROUGH AVE- 6-11-18 FOR BILLING INQUIRY: (319)291-4323
[Description I Total Price
REINSPECTION 1 $100.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
5760 06/20/2018 07/20/2018 2018-00000401 $100.00
Less Prepayment $0.00
Total Due -+ $100.00
City of Waterloo
REINSPECTION - Commercial Fire Inspection Form
Inspection Number 1314
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* 1130 Ansboruough Ave
Business Name Pizza Hut
Inspection Date* 6/11/2018
Proprietor Angel In
Business Phone 319-234-5583
Email* lnAngel73@gmail.com
Email 2 Store4346@store.npcinternational.com
Property Owner
Emergency Contact Angle In
Information
Phone 319-483-8108
Violations
Ref# Code Violation&Location Corrected
1 Properly contain exposed wiring on power pole in front of
store in a listed and rated enclosure.
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 1$150.00-Second Re-inspection I$200-Third and subsequent Re-inspections
Reports
Reports
Comment
Inspection Fee S
Occupancy Fee S
Re-inspection Fee S 100.00
Total Fee* S 100.00
Received By Clerk
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
Reinspection
Re-inspection Date Time
5 6/27/2018