HomeMy WebLinkAbout3815 UNIVERSITY AVE INVOICE DATE DUE DATE INVOICE# TOTAL DUE
hf�11lle� ��:, 02/09/2021 03/15/2021 2021-00000195 $80.00
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Customer#: 12631 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
DOLLAR GENERAL 715 Mulberry St
100 MISSION RIDGE WATERLOO, IA 50703
GOODLETTSVILLE, TN 37072
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-3 815 UNIVERSITY AVE- 1-11-21 FOR BILLING INQUIRY: (319)291-4323
L Description I Total Price
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
12631 02/09/2021 03/15/2021 2021-00000195 $80.00
Less Prepayment $0.00
Total Due $80.00
City of Waterloo
WATERLOO FIRE RESCUE �pTER�pO
INSPECTION REPORT
DOLLAR GENERAL,3815 UNIVERSITY AVE,BLDG 3815 UNIVERSITY AVE, WATERLOO IA 50701
DETAILS
Inspection Date:01/11/2021 j Inspection Type:Annual Inspection(1Yr) I Inspection Number:4181 I Shift: N/A I Station: N/A I
Unit: N/A I Lead Inspector:JEFF SIEBEL j Other Inspectors: N/A I Fee:$80.00
STATUS CODE DESCRIPTION
FAIL 604.2.12-Means of egress Emergency power shall be provided for means of egress illumination in accordance
illumination with Sections 1008.3 and 1104.5.1.
Inspector:JEFF SIEBEL-Comments:repair egress light at front above wine.
FAIL 605.6-Unapproved Open junction boxes and open-wiring splices shall be prohibited.Approved covers
conditions shall be provided for all switch and electrical outlet boxes.
Inspector:JEFF SIEBEL-Comments:replace missing outlet cover in breakroom.
GENERAL NOTES
JEFF SIEBEL-01/12/2021 @ 17:16 annual inspection$80
REINSPECTION DATE
02/01/2021
CONTACT SIGNATURE
Tina Peterson
Signed on:01/12/2021 @ 17:15 e M J' I
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INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:01/12/2021 @ 17:16
Printed on 01/12/2021 @ 17:23
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