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HomeMy WebLinkAbout1104 WASHINGTON ST INVOICE DATE DUE DATE INVOICE# TOTAL DUE 41 �►41:•, 08/13/2018 09/20/2018 2019-00010097 $100.00 Customer#: 14228 Please Make Check Payable and Remit To: City of Waterloo ATTN: City Clerk/Accounts Receivable KWIK STOP#3 715 Mulberry St 1104 WASHINGTON ST WATERLOO, IA 50703 WATERLOO,IA 50702 Amount Enclosed: DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT KEEP THIS PORTION FOR YOUR RECORDS COMMERCIAL INSPECTION- 1104 WASHINGTON ST- 8-1-18 FOR BILLING INQUIRY: (319)291-4323 L Description Total Price J REINSPECTION 1 $100.00 CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES 14228 08/13/2018 09/20/2018 2019-00010097 $100.00 Less Prepayment $0.00 Total Due $100.00 City of Waterloo ire Ins cti©�'�°rm SPEC,�I0S . C o merc,al F �E,IN 444 Inspection Number Jeff Siebel Waterloo Fire Res cue Water 5p703 Inspector* Waterloo,I 5070362 Mulberry Street 319) 1224 Fax-.71n 319)'23g" l �terloo'ia.Org Ph0 Jeff.Siebe.Siebel@waterloo-ia.org File Upload ashiington * 11 p4t W Address Kok Stop 3 Business Name * 81112p18 Inspection Date Mohammad Uyas Proprietor 319-236'38g5 Business Phone investment@YahpO.com Email* MNM mail.com GUJARI g73@9 Email 2 Mohammad llyas Property owner Emergency Contact Mohamrnd Ilyas Information I Nlian 319`830`1226 319-464-547 5 Phone Corrected Violation&Location Violationsout of service for documented as Code ks have been 13 1.3 Refit Fuel tan 4.2 one Year as of 6113118 2015 IFC section 570 1 Provide compliance Nnth �of tank inspection report 1 e so �s promised some 811 and 30 Pm 812115. additional le( store°n 719 and _ date, Visited received Yet as of 3 inspection Comments: and have not re given re-inspection insp b the g e cti •on are not corrected y t di •nspe ctr 00_Third and subsequent wring the r Re-inspection I$2 If violations noted d Second Re-insp are as follows: inspection� 150 p0- $100.00" First Re_ Reports I Reports Fire Extinguisher Service comment Superior 6/18 Inspection Fee Occupancy Fee Re-inspection Fee $ 100.00 Total Fee* $ 100.00 Received By Muhammad illyas AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM. File Upload(for long inspections) Reinspection Re-inspection Date Time 3 8/16/2018