HomeMy WebLinkAbout2765 CROSSROADS BLVD (2) INVOICE DATE DUE DAZE INVOICE# TOTAL DUE
(2.
02/14/2018 03/20/2018 2018-00000183 $80.00
°
Customer#: 14482 Please Make Check Payable and Remit To:
City of Waterloo
ATTN: City Clerk/Accounts Receivable
ASPEN DENTAL 715 Mulberry St
6600 WEIGHLOCK DR WATERLOO, IA 50703
SYRACUSE,NY 13057
Amount Enclosed:
DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
KEEP THIS PORTION FOR YOUR RECORDS
COMMERCIAL INSPECTION-2765 CROSSROADS BLVD 2-8-18 FOR BILLING INQUIRY: (319)291-4323
[Description ( Total Price j
INSPECTION 2,000 $70.00
OCCUPANCY FEE $10.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
14482 02/14/2018 03/20/2018 2018-00000183 $80.00
Less Prepayment $0.00
Total Due-- $80.00
City of Waterloo
Commercial Fire Inspection Report
Inspection Number 1274
Prior Inspection Fill this field if it is available, it will auto-fill business name and address.
Number
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* 2765 Crossroads Blvd
Business name Aspen Dental
Inspection Date* 2/8/2018
Proprietor Dr.Ala'a Al Arabi
Business Phone 319-233-2400
Email* koconnor@aspendental.com
Email 2 britsmith@aspwndental.com
Property Owner
Emergency Contact Brittany Barnes
Information
Phone 319-243-8002
Violations
Ref# CODE Violation &Location Corrected
Repair egress-exit light by front door.
2 Repair egress light by front counter
3 Repair egress light by exam room#4 .
Remove portable electric heater or provide documentation of
proper use and clearances.
4 Repair egress/exit light by back door.
5 Repair egress light by exam room 9
Ref# CODE Violation &Location Corrected
n Remove obstructions(ceiling tile/carper)to water heater. Maintain
a minimum oroo^clearance at all times.
Comments:
If violations noted during the inspection are not corrected by the given re-inspection date, additional fees
are as follows:
$1on.nU -First Re-inspection |$1on.00 -Second Re-inspection |$2oo -Third and subsequent Rn'mapeuuone
Reports
Reports Fie Extinguisher Service
Comment Summit4/1r
Inspection Fee S7U.00
Occupancy Fee S1O.00
Re-inspection Fee 5
Total Fee* 8 80.00
Received By Bittany Smith
Am INVOICE Op THIS CHARGE WILL FOLLOW. oO NOT PAY FROM THIS FORM.
File Upload (for long
inspections)
ReinSpeCtiOD
Re-inspection# Date Time
1 3/1/2O18