Fire Review Application (Permit # Unknown)sQ-G City of La Quinta z a
r FOFo ' Design and Development Department-.: _
a _ 5 78-495 Calle Tampico
La Quints CA 92253 �.
Telephone: (760)777-7125 Fax: (760)777=1233•,,
0 www.la-gdinta.ora i JUN 2 6 2017
Riverside County Fire Department
DATE PAID ST P
• Riverside Office Gil.
-Y OF LA WUIMA
2300 Market Street, Ste. 150
Riverside, CA 92501. DESIG�ND EVELOPMENT DEPARTMENT
(951)955-4777 '.
• f _. _ '^`. . 'x,.54 1
FIREREVIEW APPLICATION '
❑ NEW ❑ TENANT IMPROVEMENT PERMIT NO.'
' `PROJECT.INFORMATION
a. Print). I
Project Name: LA7�S ,- Sign: r—
i
Site`Address: 7$= 3y7 I// Print: M pyo
City & Zip:. LA -Q�rTA +
• 1 have read and understand that fees are DEPOSIT BASED FEES andthere may be additional money due prior to or
after project final: - "
• Pursuant to a Cooperative Agreement to Provide Fire Services, the - Riverside County Fire Department serves as the
City's fire department, and the County designee serves as the City's fire chief. Applicant recognizes this
contracted arrangement and shall comply with County Fire Department directions.
1APPLICANT/CONTACTANFORMATION , ', BILLING INFORMATION:( -Same as -Applicant info
Applicant Name: ULT;QA
Contact Person: �y �SE,ZG� Bill To
Mailing Address: • 3065 Vg2oOA- '_2nij : Mailing Address:
City & Zip: 1/ J� S7,a7,J6% 95P9 ` City & Zip:.. .
Phone Number: 760-o97N2-4toC Fax: Phone Number: Fax:
Email: CILI,,AC !V6'7 Email
The person listed on "Billing Information" will receive ALL billing, correspondence and refunds for any work billed to this permit. Any `
chanaes in billina information must be made in writina to our office -
A. APPLICATION TYPE (each application type includes a $5 technology enhancement fee)
FIRE SPRINKLER SYSTEM'` "'�: ," ':"
`"
STORAGE TANKS
_
❑ COMMERCIAL TI - 1-9 HEADS
NO FEE
❑ DISPENSERS ONLY
$217
❑ COMMERCIAL TI - 10 + HEADS
$619
❑ ABOVE GROUND - 1 TANK
$217
❑ RESIDENTIAL - TRACT HOME - MODELS
$619
❑ ABOVE GROUND - EACH ADDITIONAL
$32
❑ RESIDENTIAL- EACH ADDITIONAL UNIT
$126 EA'
• ❑ UNDERGROUND
$217
❑ RESIDENTIAL - CUSTOM HOME
$619
MISG
FIRE ALARM SYSTEM +,
r
❑ HAZMAT
$589
❑ COMMERCIAL - SPRINKLER MONITORING
$192
❑ HIGH PILE RACK STORAGE
$353
❑ COMMERCIAL - FIRE ALARM SYSTEM
$632
❑ NEW COMMERCIAL - UNDERGROUND
WATER
$701
SUPRESSION SYST_ EM : ,, 't +az":
` ,
_ ❑ FIRE FLOW REPORT
$178
❑ HOOD & DUCT
$215
❑ TECHNICAL REPORT RESEARCH
$589
❑SPRAY BOOTH
$215
❑ SPECIAL INSPECTION
$126
❑ CELL SITE
❑ OTHER SUPRESSION SYSTEM `
$215'
$215
❑ ITEMS NOT LISTED ARE ON A SLIDING.
SCALE STARTING AT --------------------------
$197
These are Deposit Based Fees. There may be additional money due prior to or.after. project firial.
» uruAitu