BRES2016-3014 Fire Review ApplicationCity of La Quinta
Design and Development Department
s - 78-495 Calle Tampico, ��✓_'�,..'�
La Quinta, CA 92253
mac" "aw5�• Telephone: (760)777-7125 Fax: (760)777-12IE E.I V
y0F�� ww.w.la-quinto.ora . JUL 2 8 2017
Riverside County Fire Department p�
Riverside Office JUL 28 ZOjI YUT (AQUINIAM
CI i
2300 Market Street, Ste.150 NP GN AND DEVELOPMENT DEPARTMENT
Riverside, CA 92501 CITY OF LA QUb .
- (951)955-4777 COMMUNITY DEVELOPMENT
FIRE REVIEW APPLICATION
-NEW ❑ TENANT IMPROVEMENT PERMIT NO.�S2O f�
PROJECT INFORMATION (Please Print)
Project Name: f� :Q &/)I lite ;Z_Sign:
Site Address: ��� S� 1��62rQ`(c /dl%/tG2 Print:
City & Zip: �G{: acaZ at
• 1 have read and understand that fees are DEPOSIT BASED FEES and there 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.
APPLICANT/CONTACT INFORMATION BILLING'INFORMATION: ❑ Same as Applicant.info
Applicant Name:—�� Contractor
License Number: ���j �. ���I
Contact Person: �� f K— / �' ��� `� Bill To:
Mailing Address i �' �4/ �%� Mailing Address:
City & Zip: `G City & Zip: f
Phone Number: -Fax: o Phone Number: Fax:
Email: RA le ,Cell g,,Finail:
The person listed on "Billing Information" will receive ALL billing, correspondence and refunds for any work billed to this permit
changes in billing'Information must be made in writing to our office.
Any
A. APPLICATION TYPE (each application type includes a $5 technology enhancement fee)
FIRE SPRINKLER SYSTEM
STORAGE TANKS
q 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
❑ UNDER GROUND
$217
SIDENTIAL - CUSTOM HOME
$619
MISC
FIRE ALARM SYSTEM
❑ HAZMAT
$S89
❑ COMMERCIAL.- SPRINKLER MONITORING
$192
❑ HIGH PILE RACK STORAGE
$353
❑ COMMERCIAL - FIRE ALARM SYSTEM
$632
❑ NEW COMMERCIAL - UNDERGROUND
WATER
$701
SUPRESSION SYSTEM
❑ 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.final.