HomeMy WebLinkAbout3201 W 4TH ST •
INVOICE DATE DUE DATE INVOICE# TOTAL DUE
(41411, -. . 06/04/2018 07/10/2018 2018-00000358 $80.00
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Customer#: 22019 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
METRO 66#1 715 Mulberry St
PO BOX 66 WATERLOO, IA 50703
WATERLOO,IA 50704
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-3201 W 4TH ST-6-6-18 FOR BILLING INQUIRY: (319)291-4323
LDescription Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
22019 06/04/2018 07/10/2018 2018-00000358 $80.00
Less Prepayment $0.00
Total Due— $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1517
Prior Inspection 427
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* 3201 West 4th Street
Business name Metro 66#1
Inspection Date* 6/6/2018
Proprietor Sam Annis
Business Phone 319-236-3105
Email* metrofue11@yahoo.com
Email 2
Property Owner Sam Annis
Emergency Contact Sam Annis
Information
Phone 319-231-1874
Violations
Ref# CODE Violation &Location Corrected
1
Comments: No violations noted at this time.
Fuel emergency stop tested ok
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 Superior 7/17
Inspection Fee $ 70.00
Occupancy Fee $ 10.00
Re-inspection Fee $
Total Fee* $ 80.00
Received By Kent
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
Reinspection
Re-inspection# Date Time