HomeMy WebLinkAbout1104 WASHINGTON ST INVOICE DATE DUE DATE INVOICE# TOTAL DUE
/P ink ,M 11/15/2018 12/20/2018 2019-00010167 $150.00
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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- 11-2-18 FOR BILLING INQUIRY: (319)291-4323
[Description I Total Price
REINSPECTION 2 $150.00
CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES
14228 11/15/2018 12/20/2018 2019-00010167 $150.00
Less Prepayment $0.00
Total Due—> $150.00
City of Waterloo
REINSPECTION - Commercial Fire Inspection Form
Inspection Number 444
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* 1104A Washiington
Business Name Kwik Stop 3
Inspection Date* 11/2/2018
Proprietor Mohammad Ilyas
Business Phone 319-236-3895
Email* MNMinvestment@yahoo.com
Email 2 GUJAR1973@gmail.com
Property Owner Mohammad Ilyas
Emergency Contact Mohammd Ilyas
Information
Phone 319-464-5475/Mian 319-830-1226
Violations
Ref# Code Violation &Location Corrected
1 Fuel tanks have been documented as out of service for
one year as of 6/13/18.
Provide compliance with 2015 IFC Section 5704.2.13.1.3
(provided in earlier report)
Comments:
If violations noted during the inspection are not corrected by the given re-inspection date,additional fees
are as follows:
$100.00-First Re-inspection I$150.00-Second Re-inspection I$200-Third and subsequent Re-inspections
Reports
Reports
Comment
Inspection Fee $
Occupancy Fee
Re-inspection Fee $ 150.00
Total Fee* $ 150.00
Received By Mohammad Ilyas
AN INVOICE OF THIS CHARGE WILL FOLLOW. DO NOT PAY FROM THIS FORM.
File Upload(for long
inspections)
Reinspection
Re-inspection Date Time
6 11/26/2018