HomeMy WebLinkAbout1975 FRANKLIN ST 01111-C-d""41k.iINVOICE DATE DUE DATE INVOICE# TOTAL DUE
02709/2021 03/15/2021 2021-00000206 $80.00
Customer#: 21926 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
RAY'S SUPERMARKET INC 715 Mulberry St
1975 FRANKLIN 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- 1975 FRANKLIN ST- 1-12-21 FOR BILLING INQUIRY: (319)291-4323
L Description
I < v .,.;. :Total Price::
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
21926 02/09/2021 03/15/2021 2021-00000206 $80.00
Less Prepayment $0.00
Total Due-* $80.00
City of Waterloo
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FIRE RESCUE- moo IA 50703
NKL/N sr,warEWATERLOO
S REPORT r BLpG 1975 FRA
INSPECTION R6 1 y75 FRpNIC1/N s
ors SUPERMARKET,Inspector N/A
DETAILS ection(1Yr) j Inspection Number:4316 1 Shift: N/A IStation:
Inspection Type:Annual Insp N/A j Fee:$80.00
lade
lns r:JEFF SIEBEL I Other Inspectors:
Inspection Date:01�12/2021
Unit: N/A j Lead P
DESCRIPTION covers
splices shall be prohibited.Approved
FAIL
STATUS CODE en-wiring p
unction boxes and op electrical outlet boxes.
Open jpanel.
Unapproved shall be provided for all switch andbreaker in electrical
605.6FAI
- replace missing
conditions EFF SIEBEL-Comments:
Inspector:J
published reports of
and installed and maintained
and fixtures shall be tested agency
a ed listed in p
Electrical appliances ent by an approved g
-Appliances instructions included as part of such listing.
605.7p inspected electrical h allequipment
pin � t cover in cooler.
� in accordance light Inspector:JEF F SIEBEL-Comments:Re-install moisture proof
other appurtenances shall be
fans,ducts and through 609.3.3.3.
grease-removal devices, Sections 609.3.3.1
Hoods,g required by
609.3•3-Cleaning cleaned at intervals as enload to
FAIL .Provide current semi-annual kite musthood
Comments
Inspector:)EFF SIEBEL- discrepancies corrected.Co
system cleaning with all
exhaust ine.
the compliance eng
GENERAL NOTES
)EFF SIEBEL-01/15/2021 @ 14:59
Annual Inspection Fee$80
)EFF SIEBEL-01/15/2021 @ 15:00
' hen hood fire suppression 1/7/21 Superior
kitchen
REINSPECTION DATE
02/11/2021
Printed Page 1 of
212 15:02
CONTACT SIGNATURE
Yasmine Yasmeen
Signed on:01/15/2021 @ 15:01 j
-`&Mj vJ IT--
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:01/15/2021 @ 15:01
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 01/15/2021 @ 15:02
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