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Certificate of Compliance <br />Payment of School Facility Fees <br />Santa Ana Unified School District <br />CITY OF SANTA ANA <br />Planning and Building Agency <br />App=1 <br />FOR PERMIT ISSUANCE <br />Name (First, MI, Last) <br />Carlos Gon ale <br />Telephone <br />Mastet I-D. <br />Date: <br />414-_q <br />-b3 <br />Project Address <br />2232 S LOVveI I 5�` <br />Tract/Parcel Number <br />10112.;2T1 <br />City, State, Zip Code <br />Scin+a A Lo, , CA 92101 <br />Name (First, MI, Last) <br />Telephone <br />Nature of Work <br />Use of Building (check) Type of Project (check) <br />Residential E� Commercial ❑ Senior Housing ❑ <br />New M Addition ❑ Alteration ❑ <br />Description of Project <br />Adding a00 sf -A aiterin ex1,-hn 400 sf ara <br />e for a 1,000 sf A�DU <br />Number of Square Feet of <br />Residential Space woo <br />Number of Square Feet of <br />Commercial Space <br />Sq. Ft x $ 5. I _+ <br />(Dev. Fee) <br />Sq.Ft x $ <br />(Dev. Fee) <br />Total S 5: 110.00 <br />Total S <br />The above representations as to square footage are true. Applicant agrees that if it is later determined that such <br />representations are not true, then this certificate shall automatically terminate, and the appropriate City/County shall be <br />notified. Applicant is hereby noticed that any party filing a protest regarding the imposition of fees pursuant to <br />Government Code Section 53080 must do so within 90 days from the payment of the fee. <br />,M"t1t 6,6�J 0 S--2 2 <br />Applicant Name (Please Print) Date <br />Signatu e <br />This certifies that the above -named Applicant has paid school facility fees in compliance with all existing and applicable <br />sections of the Government Code and Education Code. <br />Qmu 2 _q'NA <br />Z-� <br />S n Ana Unified School District Authorize epresentative I Date <br />DISTRIBUTION <br />White - City/County <br />Canary - Applicant <br />Pink - Facilities <br />