HomeMy WebLinkAboutUntitled Certificate No. 20121023 — 352
ARCADIA UNIFIED SCHOOL DISTRICT
150 South Third Avenue,Arcadia, CA 91006 • (626) 821-8300 Ext. 6732
(Certificate of Compliance with Fee Provisions of Government Code Section 65995)
This new Fee Schedule is effective December 26,2012.
Any Developer Fee Worksheet brought in on or after this date will be charged at the new rate.
Address of Development:
604 N. Santa Anita Ave . , Arcadia , CA 91006
Number of Buildings in Project: one Plan Check Number: 14-413
I 11 [ ]
Exempt' (500 sq. ft.or less. Residential2 Commercial/Industrial Commercial/Industrial
Future additions chargeable $3.20/sq. ft. $0.51/sq.ft. Parking Structure
at regular rate) $0.26/sq. ft.
Area in Sq. Ft.: A developer may request refund of fees to the
2 , 200 District within twelve months of payment of fees,
Developer Fee: $ in the event the Building Permit expires or the
1 , 12 2 .00 project is canceled. The refund will be reduced by
a $100 administrative fee. The refund check will
Receipt No. [xi 317901 [ 1 N/A be issued in the name of the original payee and
mailed to the address of payee.
Owner: Am Chen Developer:
y
Address: 604 N. Santa Anita AVe Address:
Arcadia, CA 91006
Home Phone: 626-484-3573 Business Phone:
Pager/Cell Phone: Pager/Cell Phone:
'This is to certify that the above-described development has been determined to be exempt from the developer fees
of Government Code Section 65995 and a Building Permit may be issued therefore.
2This is to certify that all fees due to the Arcadia Unified School District, under provision of Government Code
Section 65995, as a prerequisite to the issuance of a Building Permit by the Building Department of the
Development Services Department,have been received. Based on the information presented above,this Certificate
of Compliance is hereby executed.
D The District charges a $100 fee to process reinstatement of the Developer Fee Certificate of Compliance
resulting from an "insufficient funds" check in addition to a $35 fee for the bounced check. Only cash or a
Cashier's Check will be accepted as payment thereafter.
D The District charges a $100 fee for any amendments to or cancellation of a Developer Fee Certificate of
Compliance issued on any type of development. Said request for refund of fees paid to the District must be
made within twelve months of payment of fees.
Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that
the information he/she provided herein is true d accurate . the best of his/her knowledge.
Signature of Applicant:
4111
District Approval: �� �� Date: 1/20/15
WHITE-Applicant YELLOW-Accounting Dept. PINK-Business Services Certificate of Compliance(10-23-12)
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