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�pN'f A qN- <br />\sCH00�►�`� <br />Certificate of Compliance <br />Payment of School Facility Fees <br />Santa Ana Unified School District <br />Name (First, MI, Last) <br />H Umberto A Malri(A Garcia <br />Project Address <br />140 W . St-. Andrew -Pl. <br />City, State, Zip Code <br />Name (First, MI, Last) <br />Santa Avia , CA 9240'1 <br />CITY OF 51kNTA ANA <br />Planning and Building Agency <br />APpAlzi <br />FOR PERMIT ISSUANCE <br />Telephone iviaser iu: <br />Date: <br />-414-4 3--11 <br />Tract/Parcel Number <br />10112221DO <br />Telephone <br />Use of Building (check) Type of Project (check) <br />Residential 1� Commercial ❑ Senior Housing ❑ New ❑ Addition d Alteration d <br />Description of Project <br />Convert aara cie A add zed floor -6 AW <br />Number of Square Feet of <br />Residential Space <br />Number of Square Feet of <br />Commercial Space <br />961 <br />Sq.Ft x $ <br />Sq.Ft x $ <br />5.1-f <br />(Dev. Fee) <br />(Dev. Fee) <br />Total $ 4,g13.54 <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 />sexr4-� <br />Applicant `Fume (Please Print) <br />ure <br />/Z <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 GovAnment Code and Education Code. <br />f Of I aol/tA� <br />Authorized Representative <br />Date <br />DISTRIBUTION <br />While - City/County <br />Canary - Applicant <br />Pink - Facilities <br />