HomeMy WebLinkAbout321 W 4TH ST -�► � INVOICE DATE DUE DATE INVOICE# TOTAL DUE
Awl Ink ri� 03/23/2021 04/26/2021 2 -iktheilif't �!l.3 021 00000235 $80.00
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Customer#: 10626 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
LA PLACITA MEXICAN STORE 715 Mulberry St
321 W 4TH ST WATERLOO, IA 50703
WATERLOO, IA 50701
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-321 W 4TH ST-3-8-21 FOR BILLING INQUIRY: (319)291-4323
L Description
Total Price J
INSPECTION 2,000 $70.00
OCCUPANCY FEE
$10.00
CUSTOMER# I BILLING DATE I DUE DATE I INVOICE#
10626 03/23/2021 04/26/2021 2021-00000235 CHARGES
$80.00
Less Prepayment $0.00
Total Due--* $80.00
City of Waterloo
WATERLOO FIRER RESCUE �pSER{p0
INSPECTION REPORT
LA PLACITA,321 W 4TH ST,BLDG 321 W 4 TH ST,WATERLOO IA 50702
DETAILS
Inspection Date:03/08/2021 1 Inspection Type:Annual Inspection(1Yr) 1 Inspection Number:4513 I Shift: N/A i Station: N/A l
Unit: N/A I Lead Inspector:JEFF SIEBEL I Other Inspectors: N/A I Fee:$80.00
STATUS CODE DESCRIPTION
FAIL 604.2.5-Exit signs Emergency power shall be provided for exit signs as required in Section 1013.6.3.The
system shall be capable of powering the required load for a duration of not less than
90 minutes.
Inspector:JEFF SIEBEL-Comments:repair egress/exit light above exit door to W 4th
street.
FAIL 609.3.3-Cleaning Hoods,grease-removal devices,fans,ducts and other appurtenances shall be
cleaned at intervals as required by Sections 609.3.3.1 through 609.3.3.3.
Inspector:JEFF SIEBEL-Comments:provide current semi-annual kitchen hood
exhaust cleaning inspection report with all discrepancies corrected.Contractor must
upload online to the compliance engine.
FAIL 609.3.3.3-Records Records for inspections shall state the individual and company performing the
inspection,a description of the inspection and when the inspection took place.
Records for cleanings shall state the individual and company performing the cleaning
and when the cleaning took place.Such records shall be completed after each
inspection or cleaning and maintained.
Inspector:JEFF SIEBEL-Comments:provide current semi-annual kitchen hood
exhaust cleaning inspection report with all discrepancies corrected.Contractor must
upload online to the compliance engine.
GENERAL NOTES
JEFF SIEBEL-03/10/2021 @ 08:41 annual fire inspection$80
JEFF SIEBEL-03/10/2021 @ 08:42 Hood fire suppression proshield 11/12/20
JEFF SIEBEL-03/10/2021 @ 08:43 fire extinguishers due in may
Printed on 03/10/2021 @ 08:46
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REINSPECTION DATE
03/29/2021
CONTACT SIGNATURE
Manuel Lopez
Signed on:03/10/2021 @ 08:44 Ke . c7/ 1 'b
4'M A ttil
INSPECTOR SIGNATURE
JEFF SIEBEL
Signed on:03/10/2021 @ 08:44
QUESTIONS ABOUT YOUR INSPECTION?
JEFF SIEBEL
Jeff.Siebel@Waterloo-ia.org
3192301224
Printed on 03/10/2021 @ 08:46
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