HomeMy WebLinkAbout244 ASH ST INVOICE,DATF DUE DATE INVOICE# TOTAL DUE
0\111al� -' 08/13/2018 09/20/2018 2019-00010084 $50.00
dPIVNIS
Customer#: 11613 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
KNIGHTS OF PYTHIAS 715 Mulberry St
244 ASH ST WATERLOO, IA 50703
WATERLOO,IA 50703
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-244 ASH ST- 8-6-18 FOR BILLING INQUIRY: (319)291-4323
[Description Total Price j
INSPECTION 1 $40.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
11613 08/13/2018 09/20/2018 2019-00010084 $50.00
Less Prepayment $0.00
Total Due--- $50.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1696
Prior Inspection 533
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* 244 Ash Street
Business name Knights of Pythias-Furgerosn Lodge#5
Inspection Date* 8/6/2018
Proprietor Leon Mosley
Business Phone 319-269-1857
Email* RX27162@ME.Com
Email 2
Property Owner
Emergency Contact Robert Mosley. 319-231-6727
Information
Phone Charlie Brown 319-830-4534
Violations
CODE Violation &Location Corrected
Ref#
1 Repair exit sign by pool table
2 Remove extension cord by DJ booth
3 Remove propane storage from inside building . Propane must be
stored outside building secured and in upright position.
4 Provide annual service for fire extinguishers. Replace missing 2A-
10BC fire extinguisher by kitchen
5 Remove obstructions. Maintain a minimum ol 36"clearance to
water heater at all times.
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 I$150.00 -Second Re-inspection I$200 -Third and subsequent Re-inspections
Reports
Reports
Comment
Inspection Fee S 40.00
Occupancy Fee S 10.00
Re-inspection Fee S
Total Fee* S 50.00
Received By Leon Mosley
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
Reinspection
Re-inspection# Date Time
1 8/27/2018