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Name (First, MI, Last) <br />Project Address <br />City, State, Zip Code <br />Name (First, MI, Last) <br />CITY OF SANTA ANA <br />Planning and Building A encyl <br />Certificate of Compliance �j *� <br />51 <br />Pavment of School Facility Fees App544 <br />Santa Ana Unified School District FOR PERMIT ISSUANC <br />Telephone Date: <br />Tract/Parcel Number <br />Telephone <br />Use of Building (check) 1 Type of Project (check) <br />Residential Commercial ❑ Senior Housing ❑ I New ❑ Addition l� Alteration <br />Description of Project <br />Caoxcme +o ADU covwe,s'lon vv.�A" addifi©n <br />Number of Square Feet of <br />Residential Space 38 (- Z5 <br />Sq.Ft x $ 6 • IT <br />(Dev. Fee) <br />Number of Square Feet of <br />Commercial Space Sq.Ft x $ <br />(Dev. Fee) <br />Total $ 1.911, Rio <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 parry 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 />Ek'a-ma'-9 WY c>►1 P) Q <br />Applicant Name (Please Print) Date <br />Signature <br />This certifies that the above -named Applicant has paid school facility fees in compliance with all existing and applicable <br />sections of the Gove ent Code and Education Code. <br />Sant a Unifie chool District nthorized Representative Date <br />DISTRIBUTION <br />White - CitylCounty <br />Canary - Applicant <br />Pink - Facilities <br />