HomeMy WebLinkAbout3700 UNIVERSITY AVE INVOICE DATE DUE DATE INVOICE# TOTAL DUE
A r alF4, 09/04/2018 10/10/2018 2019-00010120 $80.00
Vloo \o
Customer#: 22164 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
HY-VEE GAS 715 Mulberry St
3700 UNIVERSITY AVE WATERLOO, IA 50703
WATERLOO,IA 50701
Amount Enclosed.-
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-3700 UNIVERSITY AVE- 8-27-18 FOR BILLING INQUIRY: (319)291-4323
LDescription 1 Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
22164 09/04/2018 _ 10/10/2018 2019-00010120 $80.00
Less Prepayment $0.00
Total Due— $80.00
City of Waterloo
Corn -rcial_Fire Inspection Report
Inspection Number 1760
Prior Inspection 72
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* 3700 University Ave
Business name Hy-Vee Gas
Inspection Date* 8/27/2018
Proprietor Hy-vee
Business Phone 319-232-2119
Email* 1869cstoremgr@hy-vee.com
Email 2
Property Owner Brian Brunsen
Emergency Contact Brian Brunsen
Information
Phone 319-230-1689
Violations
Ref# CODE Violation &Location Corrected
1 NFPA 72 Provide current annual fire alarm inspection/testing report with all
deficiencies corrected by a contractor certified to perform work in
the State of Iowa.
2 Repair in use moisture proof outlet covers on outdoor outlet:
A. By Ice machine
B.By South West front corner of coffee shop
3
Comments: ESD functions 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
Inspection Fee $ 70.00
Occupancy Fee S 10.00
Re-inspection Fee $
Total Fee* $ 80.00
Received By Brian Brunsen
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
Reinspection
Re-inspection# Date Time
1 9/17/2018