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CITY OF SANTA ANA <br />SphfA Planning and Building Agenc <br />Certificate of Compliance 522 <br />Payment of School Facility Fees Approved <br />°fcNoo�°� Santa Ana Unified School District FOR PERMIT ISSUANCE <br />Name (First, MI. Last) Telephone Ma <br />un Train A Lista Tham 114 2100 4 I <br />Project Address Tract/Parcel Number <br />11i W "Brook St , 5ui+e #Z I0lt20V}8 <br />Citv, State, Zip Code <br />Santa Ate, CA 12103 <br />Name (First, Ml, Last) I Telephone <br />Use of Building (check) Type of Project (check) <br />Residential I? Commercial ❑ Senior Housing ❑ New M Addition ❑ Alteration ❑ <br />Description of Project <br />New attached ADU -io exi s- inq de+ached garage <br />Number of Square Feet of <br />Residential Space �qq <br />Number of Square Feet of <br />Commercial Space <br />Sq.Ft x $ 5.14 <br />(Dev. Fee) <br />Sq.Ft x $ <br />(Dev. Fee). <br />Total S 4,i30.S3 <br />Total $ <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 />Applicant4NawPlease Print) <br />Signatur <br />Date <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 />llN42 5 <br />VSataAna Unified School District Ant h ized Representative Date <br />DISTRIBUTION <br />While - City/County <br />Canary - Applicant <br />Pink - Facilities <br />