HomeMy WebLinkAbout1761 INDPENDENCE AVE ;�'!. INVOICE DATE DUE DATE INVOICE# TOTAL DUE
JAI1�o�,► r�r�- 09/04/2018 10/10/2018 2019-00010126
�•.ri# $80.00
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Customer#: 15370 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
INDEPENDENCE LIQUOR 715 Mulberry St
1761 INDEPENDENCE AV WATERLOO, IA 50703
WATERLOO,IA 50703
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION- 1761 INDPENDENCE AVE- 8-23-18 FOR BILLING INQUIRY: (319)291-4323
LDescription Total Price
J
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
15370 09/04/2018 10/10/2018 2019-00010126 $80.00 _
Less Prepayment $0.00
Total Due $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1743
Prior Inspection 95
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* 1761
Business name Independance Avenue U:‘ - 4 C I cc)d
Inspection Date* 8/23/2018
Proprietor Florinda
Business Phone 319-234-0089
Email* Cindy.Young@waterloo-ia.org
Email 2
Property Owner Eagle Corportation
Emergency Contact
Information
Phone
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.
Also clean filters.
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 Repair main door exit/egress light.
Comments: listed oily waste receptacle on site.
Fire extinguishers due in September
If violations noted during the inspection are not corrected by the given re-inspection date, additional fees
are as follows:
S100.00 -First Re-inspection I$150.00 -Second Re-inspection I$200 -Third and subsequent Re-inspections
Reports
Reports
Comment
Inspection Fee S 70,00
Occupancy Fee S 10.00
Re-inspection Fee S
Total Fee* S 80,00
Received By Gagen
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
Reinspection
ez rAl DO‘g
Re-inspection# Date .„ . Time
1