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Home My WebLink About2325 MICA RD; ; CB080009; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 04-20-2011 Residential Permit Permit No: CB0B0009 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: 12/29/2010 2325 MICA RD CBAD RESDNTL 2132820700 $431,806.60 Sub Type: Lot#: Construction Type: Reference #: SFD 33 VN CT040016 Status: Applied: Entered By: # Dwelling Units: 1 Structure Type: SFD Issued: Bedrooms: 4 Bathrooms: 4.5 Inspect Area: Project Title: VIRIDIAN-LA COSTA GREENS-PH$ 7 Orig PC#: PLAN 3: 4062 SF LIV -482 SF GAR -120 SF DECK-175SF cov. Plan Check# PORCH Applicant: TAYLOR MORRISON OF CA, LLC 15 CUSHING IRVINE 92618 949-341-1289 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Plan Check Discount Strong Motion Fee Park in Lieu Fee Park Fee LFM Fee Bridge Fee Other Bridge Fee BTD #2 Fee BTD#3 Fee Renewal Fee Add'I Renewal Fee Other Building Fee HMP Fee Pot. Water Con. Fee Meter Size Add'I Pot. Water Con. Fee Reel. Water Con. Fee Green Bldg Stands (SB1473) Fee $1,711.77 $0.00 $1,112.65 $0.00 ($89.01) $43.18 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4,878.00 03/4 $182.00 $0.00 ?? Owner: TAYLOR MORRISON OF CA, LLC 15 CUSHING IRVINE CA 92618 949-341-1289 Meter Size Add'I Reel. Water Con. Fee Meter Fee SDCWAFee CFO Payoff Fee PFF (3105540) PFF (4305540) License Tax (3104193) License Tax (4304193) Traffic Impact Fee (3105541) Traffic Impact Fee (4305541) Sidewalk Fee PLUMBING TOTAL ELECTRICAL TOTAL MECHANICAL TOTAL Housing Impact Fee Housing lnlieu Fee Housing Credit Fee Master Drainage Fee Sewer Fee Additional Fees Fire Sprinkler Fees TOT AL PERMIT FEES ISSUED 12/27/2007 JMA Plan Approved: 12/29/2010 PY PC060023 PC070086 $0.00 $190.00 $4,492.00 $3,122.05 $7,858.88 $0.00 $0.00 $0.00 $2,286.80 $0.00 $0.00 $174.00 $60.00 $103.00 $0.00 $0.00 $0.00 $0.00 $2,018.00 $125.00 ?? $28,268.32 Total Fees: $28,268.32 Total Payments To Date: $28,268.32 Balance Due: $0.00 Inspector: FINAL APPROVAL Date: / D • / 2 · I ( Clearance: ------ NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of tees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and tile the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection lees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any . n I hi h V r v· . . . f ' . . n i h i City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-29-2010 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW 100465 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: Applicant: 2325 MICA RD CBAD SWPPP 2132820700 CB080009 VIRIDIAN: PHS. 7 TAYLOR MORRISON OF CA, LLC 15 CUSHING IRVINE CA 92618 949-341-1289 Emergency Contact: GARY BOUCK 949-246-7922 SWPPP Plan Check SWPPP Inspections Additional Fees TOTAL PERMIT FEES Status: Lot#: 33 Applied: Entered By: Issued: Inspect Area: Tier: Priority: Owner: TAYLOR MORRISON OF CA, LLC 15 CUSHING IRVINE CA 92618 949-341-1289 ISSUED 11/23/2010 JMA 12/29/2010 1 M $0.00 $208.00 $0.00 $208.00 Total Fees: $208.00 Total Payments To Date: $208.00 Balance Due: $0.00 FINAL APPROVAL DATE_ ----.-·CLEARANCE __ _ SIGNATURE ______________ _ Cltv of Carlsbad ~ -~ Fin al Building Inspection --~,p-· , Dept: Building Engineering Planning CMWD St Lite Fire S[P 1 2 2J11 Plan Check#: Permit#: Project Name: PC070086 CB080009 VIRIDIAN-LA COSTA GREENS-PHS 7 Date: 09/09/2011 Permit Type: RESDNTL Sub Type: SFD PLAN 3: 4062 SF LIV -482 SF GAR -120 SF DECK -175S Address: 2325 MICA RD Lot: 33 Contact Person: Phone: Sewer Dist: CA Water Dist: CA .... , .................................................................................................................................................... . Inspected A Date ~/B/'.n ~ By: 7 ~ Inspected: Approved: Disapproved: __ Inspected Date By: Inspected: Approved: Disapproved: __ Inspected Date By: Inspected : Approved: Disapproved: __ .......................................................................................................................................................... , Comments: ______________________________ _ City of Carlsbad Bldg Inspection Request For: 10/11/2011 Permit# CB080009 Inspector Assignment: PY Title: VIRIDIAN-LA COSTA GREENS-PHS 7 Description: PLAN 3: 4062 SF LIV -482 SF GAR -120 SF DECK -175SF COV. PORCH Sub Type: SFD --- Type: RESDNTL Job Address: 2325 MICA RD Suite: Location: Lot 33 Phone: 9492467922 lnspeclor. dL APPLICANT TAYLOR MORRISON OF CA, LLC Owner: TAYLOR MORRISON OF CALIFORNIA L L C Remarks: Total Time: CD De~cription 19 Final Structural 29 Final Plumbing Act Requested By: GARY Entered By: JANEAN Comments V/b Mr1,yv /4,✓f,,,,-s~ 39 49 Final Electrical Final Mechanical fil --------------------~~~-- --------------------------·- Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# PC060023 SW100462 FINAL SW100463 ISSUED SW100464 ISSUED VIRIDIAN: PHS. 7; VIRIDIAN: PHS. 7; VIRIDJAN: PHS. 7; SW100465 ISSUED VIRIDIAN: PHS. 7; SW100466 ISSUED VIRIDIAN: PHS. 7; SW100467 ISSUED VIRIDIAN: PHS. 7; Inspection History Date Description Act 09/07/2011 39 Final Electrical co 08/22/2011 39 Ffnal Electrical PA 07/05/2011 82 Drywall/Ext Lath/Gas Test AP 07/01/2011 17 Interior Lath/Drywall NR 06/27/2011 16 Insulation AP 06/23/2011 84 Rough Combo AP 06/16/2011 13 Shear Panels/HD's AP 06/14/2011 13 Shear Panels/HD's AP lnsp Comments PY MISSING BREAKER PY PY TP PY PY PY PY •• LOT 3? CBO'?J O oo INSTALLATION CERTIFICATE CF-6R--ENV-01 (Page 1 of3) Enforcement Agency: Permit Number: If more than one person has responsibility for installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check boxes require to be checked to e~ure the mandatorv measures have been met. Description of Insulation 1. RAISED FLOOR Material: ________ ...... -+-1-_...--\----Brand Name: _____________ _ Thickness (inches): Thermal Resistance (R-ValueJ: ______ _ □ §150(d): Minimum R-13 insulat10 m raised wood-frame floor or equivalent U-factor. 2. SLAB FLOOR/PERIMETER Material=----------1-1---1--..--A--- Thlckness (inches)=------+-+-----1~-- Perimeter Insulation Depth (inches): ____ _ .Brand Name: --------------Therm al Resistance (R-Value}: ______ _ D § 150(1): Water .absorption rate for the insulation material alone without facings is no greater than 0.3 %; water vapor permeance rate is no greater than 2.0 perm/inch and shall be protected from physical damage and lN light deterioration. 3. EXTERIOR WALL a. ~ll.,ype (e.x. Batt, Loose Fill, Spray Foam) D_\? a. Thermal Resistance (R-Value): -"-·--~--- b .. Insulation Type (e.x. Batt, Loose Fill, Spray Foam) -Br-a-nd-: ==:G:::v..QJ...==~~-\_· ()./\/). ______ _ b. Thermal Resistance (R-Value): ______ _ Spray/Loose fill) Installed Actual Thickness (inches): ____ _ _Spray/Loose fill) Contractor's min installed weight/ft2 __ lb Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) D §150(c): Minimum R-13 insulation in wood-frame wall or equivalent U-factor. .Exterior Foam Sheathing (rig' Material: sulation) ----------tl-'a'+-lt-::J-----Th i c kn es s (inches) : ____ ..__ ____ _ 4. FOUNDATIONWALL ~ Material: . Thickness (inches): 'rJ. 5. CEILING O .1-\-. Batt or Blanket Type: ___ M, __ ~\~ l ___ _ Loose Fill Type: __________ _ Spray Foam Type:---------=------- Brand Name: --------------Th eon al Resistance (R-Value) : ______ _ Brand Name: -------------Thermal Resistance (R-Value):. ______ _ Brand Name: G:-u...evi. ~I~ Thermal Resistance (R-Value): 7<-3l{ Brand Name: ___________ _ ~ """l 11_ Installed Actual Thickness (inches):~..,,..!~...___ Contractor's min installed weight/ft2 ___ lb Manufacturer's installed weight per square foot to achieve Thennal Resistance (R-Value): D §lS0(a): Minimum R-19 insulation in wood-frame ceiling or equivalentU-factor. R ATIIC RADIANT BARRIER Brand Name: ___________ _ Material: _______ .......;_--+-___ --+__...--1----Brand Name: ____________ _ Thickness (inches):__________ Thermal Resistance (R-Value): ______ _ D §118(a): Insulation installed meets Standards for Insulating Material. □ §150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16. 2008 Residential Compliance Forms August2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope -Insulation; Roofing; Fenestration (Page 2 of3) Site Address: I Enforcement Agency: I Permit Number: . Description of Roofini?; Products CRRC Product ID Manufacturer Product ~ 1/si~of Product lrutial Solar Aged Solar Thermal Number1 Information Brand/Model Type_ ope Weight2 Reflectance Reflectance 4 Emittance ' V/ I\ □' / 1:1 □3 03 1. T1ie CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at ww.coolroofs. org/productslsearchphp 2. The weight in lbs per square feet of the roofing product being installed. 3. Check box if the Aged Reflectance is a calculated value using the equation below, footnote 4. 4. If the aged reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the initial reflectance value from the directory and use the eQuation (0.2+0. 7 (O;nwal -0.2) to obtain a calculated aied value. ✓ 0 CHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT "COOL ROOF" REQUIREMENT: □ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool Roof criteria. D Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 lb/ff is exempted from the above Cool Roof criteria. To apply Liquid Field Applied Coatings, the coating must be applied with a minimum dry mil thickness of 20 mils across the entire roof surface and meet minimum oerformance reauirements listed in §I J8(i)3 and Table 118-C. Select the armlicab!e coatinf{ D Aluminum-Pi1m1ented Asphalt Roof Coating ID Cement-BasedRoofCoating I D Other ✓ 0 CRRC-1 Label Attached to CF-6R (Note if no CRRC-1 label is available, this compliance method cannot be used and another method is required to meet compliance). FENESTRATION/GLAZING Product # Total Quantity Add. Exterior Co:cnments/ Manufacturer/Brand Name U-Product of NFRC of Like Product Area Shading Dev. Location/ Special Item (GROUP LIKE RODUCTS) factor1 SHGC1 Panes Certifie~2 (Optional) ft2 or Overhang Features 1 "' I // 2 '\.. I I\ 3 / t7 / / 4 5 6 7. 8. 1. Use values from a fenestration product's NFRC Certified Label. For fenestration products without an NFRC label, use the default values from Section 116, Table 116-A and 116-B of the 2008 Energy Efficiency Standards. 2. NFRC Label Certificates shall not be removed until the buildin1< inspector has verified the efficiencv. Enter Yes or No. D § l l 6(a) 1: Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. D §116(a)2 and 3: Actual fenestration products installed are equivalent to or have a lower U-factor and/or a lower SHGC than that specifioo on the Certificate of Compliance (Form CF-lR). D § l 16(a)4: Fenestration products (except field-fabricated windows) have a label listing the certified U-Factor; certified Solar Heat Gain Coefficient (SHGC), and infiltration that meets the requirements of §10-11 l(a) D §117: Exterior doors and windows weather-stripped; all joints and penetrations caulked and sealed. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope -Insulation; Roofin2; Fenestration (Page3 of3) Site Address: \ Enforcement Agency: I Permit Number: DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California. the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person respollSlble for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms .. to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF-lR) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed cin the CF-lR that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the bmlder provides to the bw1ding owner at occupancy. Company N ling Subcontractor o 4-ilX'"1-l~i,.J~ Res 2008 Residential Compliance Forms August2009 AUG-19-2009 WED 12:41 PM CITY OF CARSLBAD FAX NO, P, Ol .-2.. 3 Zs M.t cA C 13 oSooo9 «~ .. , •..:':ti!-··~.'1·'. .... -..;:,,, , .. • ~-·.CITY OF CARLSBAD CIRCUIT CARD 8-36 Development Services Building Department 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov nns CARD MUST BE l'ILLEr) OUT AND AVAILABLE !,.TTJ·1a SllRVJCt\JWU)PMl!NTl'()I'<, Tii.ll ROUGH rNsrr.cnON Address: Permit Numbor: Owner: I Phone'. I Phone: Aree In Sq. Ft. Contractor: PANE!.: ...... ~ ... --.. --~~ ..................... ,, , . .. , --"''' A.LC. VOLTS 0 WIRE -· LOCATION CKT BKR WIRE MISC REC REC LTG MISC WIRE BKR CKT SIZE SIZE T'Y'PE SIZE. TVl'li: SIZE LOCATION Air✓ 1 '10 <( ~ 17__ lL. zo 2 C,4,-f; A1 & ~----i./0 '6 '.'.IA . /?_---llA J Zc) 4 CJ.db /i1 c__ 5 <-tO i JJ I 11.. ~ Zo 6 · LAb f-n .+I<./ 7 '-ID ~ IA 7' 12-"'£!. ""Z.-0 8 11\. (,,,F, F/41 9 /c; ,~ IJ IY \A 1€' 10 S.(f ,J ,.-,',I. I fAu 11 Is /<-( JA !3 5 I'{ w. IS-12 /.,.,f-7' ( -""'-~ 13 I~ , ... , ~A 5 s (,,, f'{ Ill, J< 14 r;.,..+tZr (..,.,;;; 12!J.z.,; 15 15 /L' l z-ID /0 1 /Y f .u /~ 16 13u.v '-I u IV\ . e, ,t'M 17 I.C: r-1 ~- II I /O ,~ Ctt IC-18 £,J f,t,.J J--\411., I~ /ti ,_ &, .5 i~' r1,1 L; ,/ . /lr.,i' 19 /v I /~ 20 U;V.3 = 21 /§ Jt./ \11 ..., (_ 7 {y U\ I~ 22 ~le r'\C /titvr1.,, 2-2:; J'!i J:1._., ~-~ ~II 7 9 {vf rA~ /~ 24 Ph.lou11 1-io :0 fi;:...Lfi 25 /'7 N r._ 5 7 26 27 28 ----.-.~· 29 30 --, 31 32 ~-· 33 34 35 36 37 38 39 I 40 ··--~· 41 42 --- MAIN:□ zze;-AMP BRK/FUSE O MLO Cornputed Load AMPS BUS; AMP S,>e Ca/cuiauon Work.s/)ee/ an t>ack Sarvicu entrance or 1eeder condt..u;tors~ Branch circuits required: A) Size; No._ B) Type: D CU DAL A) Lighting Circuils 220 -3(b), 4(d) B) Two Small Appllarice Circuits 210-i1(e) C) Insulation; 0) Conduit Size: _ C) Leiundry Circuit 220 -i6(b) Service ground/bond: 8) Type: ~ [) AL D) Central Healing Equipment 422 -12 ~e:Na. -z_ E) Bathroom :110 · 52(d) C) !an,p location(~): UFER 250 -50(c) Rom;irKs: D Waler Pipe 250 -104 _ ....... ~~SRod 250 -52 GFC~.eilions 210 -· B, 6110-70: ~ch<in / cen/fy th.it ell terminations have been torqued in accordance wi/11 manufacrur@r·s ~;:ithroom(s) inslrvations and tnat the work shown on this circuir cord represonts tlla full QXtant of ~ar«1g~(~) • )"rlromassa9e'Tub tiff, work performed unde;r this permit, . utdoors D ,_ □Owner AFC~o1ecled Gire, 210-t2 ·-=--o contract~~"f S ~ eZe,c-;;c_ I. Bedroom( s) □ Signed~ · Date ~------·-- B-36 Paga 1 of 2 Rev, 03J09 _BUG-!.~-2009 WED 12:41 PM CITY OF CARSLBAD FAX NO. 760 602 B55B \7L4,:) 'b ~ P, Ol ......... CIRCUIT CARD B-36 Development Services Building Department 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov nns C:All.D MtJSi BE PILLED OUT AND AV AILAllL'E,. T Ttra Sfill VIC~ J!OUlPMll.NT l'OR lll,B ROUGU INSFllCTION Address: Permit Number. Owner: I Phone: Contractor: I Phone: Area In Sq. Ft. l'ANf:T.:_, ·--·---···--·······--······· .... -... ~. ,, ., -... ' ... , ... , A.LC. VOLTS 0 WIRE LOCATION CKT BKR WIRS. MISC REC REC LTG MISC WIRE BKR CKT SIZE SIZE l'l'PE SllB 'f\'1'1, SIZE LOCATION \Iv .Ac..~ 1 w /2. Q q; G... '-10 2 o.J~ l;J,O. 3 7.;i I z_ ru -~-r .. LfU 4 o!DM. Dw 5 2,-\ I z.. ~ ll-(\. lo 6 £.er (v\\ { 1 7 L.cJ IL (\,, LI IZ-r. C:c, 8 ~A l'..iF-i \-1,-,l"lr-, 9 "2.<) (7--(1.: '-I /2. f' .. 2.-o 10 1u+Gn DirJL-11 2o '7... f,,A 1/ '-{ IZ-(' ... 2..c.J 12 ~+Gfi l)J u,JL-, 13 "Z..u /2-~ tj 4 !1-r:. "Z...t;I 14 ~t-6p, l""l>NBYLI 15 I~ /'{ Ct. 7 .7 5 .s t,J (\tA I~ 16 f~tM lufr.lJI\J 17 IS-fl/ ¼ I !"J '1 7 I<./ ~l~ IS 18 ~f.,,v\ 19 20 21 22 23 24 .,._..,._ 25 26 27 28 -------· 2Q 30 ... ,_ 31 32 33 34 35 36 37 38 ---39 i 40 ............... 41 42 MAIN:□ zz.r AMP BRK/FUSE O MLO Computed Load AMPS BUS; AMP SMI CeJc,,Jauon Worlc.shsel on bllCII Service, anlrai,ce or leader conducior,;'. Branch circuits required: A) Size: No. 8) Type: 0 CU D AL A) Lighting Circuits :!20 -3(b), 4(d) B) Two Small App!lenoe Clrculls 210-11(e-) C) Insulation; D) Conduit Size:_ C} Laundry Circuit 220 -16(b) Service ground/bond: 1£ClAL D) Central Heatlr,g Equipment 422-12 A) Size: No. _ L B) Type: E) Bathroom :?10-52(d) ~mp location(&): LIFER 260-5D(c) Remarks: 0 Willer Pipe 250-104 ...... ~~Rod 250-52 -·-. _J GF~lioni; 210-· 8, 680-70; I cerllfy that all terminations hsve been torqued in acoon:lance with manufacturer·s ti\hroom(s) (!!-1{.!lchen inslrucl/ans snd thst ths work ~·hawn on this circuit csrd represonls fhg full El,ctent of C!l't:larag,.(,;) [9i'(ydromH&age 'Tub 1hs work porformt1d under this perm;t. ~!doors D . -Downer AFC~cled Gire, 210-12 □ Contractor~~?;.. 1.· edroom(s) D Signed~ Date ......, ____ B-36 Page 1 of 2 Rev. 03/09 ~' ~· CITY OF CARLSBAD CERTIFICATION OF SCHOOL FEES PAID B-34 Development Services Building Division 1635 Faraday Avenue ~-2719 www.carlsbadca.gov This form must be completed by the City, the applicant, and the appropriate school districts and returned to the City prior to issuing a building permit. The City will not issue any building permit without a completed school fee form. Project Name: VIRIDIAN ----------------------------- Building Permit Plan Check Number: PC09-84 Project Address: 2326 Mica Rd. ----------------------------- A.P.N.: 213-282-07-00 Project Applicant Taylor Morrison (Owner Name): _....a;.. _________________________ _ Project Description: Single Family Home Building Type: Residential ----------------------------- Residential: New Dwelling Unit{s) 233 Sq. Ft of Living Area in New Dwelling (added to original 3829sf) Second Dwelling Unit: Square Feet of Living Area in SDU ----------------------------- Residential Additions: Net Square Feet New Area Commercial/Industrial: Net Square Feet New Area -------'------------------------City Certification of Applicant Information: Ja,netA'ltl;u-Date: 04/13/2011 SCHOOL DISTRICTS WITHIN THE CITY OF CARLSBAD IZI Carlsbad Unified School District 6225 El Camino Real Carlsbad CA 92009 (760-331-5000) Encinitas Union School District 101 South Rancho Santa Fe Rd Encinitas, CA 92024 760-944-4300 ext 166 □ Vista Unified School District 1234 Arcadia Drive Vista CA 92083 (760-726-2170) D San Marcos Unified School District 215MataWay San Marcos, CA 92069 (760-290-2649) Contact: Nancy Dolce (By Appt. Only) San Diegulto Union High School District 710 Encinitas Blvd. Encinitas, CA 92024 (760-753-6491 ext. 5514) ointment onl Certification of Applicant/Owners. The person executing this declaration ("Owner") certifies under penalty of perjury that (1) the infonnation provided above is correct and true to the best of the Owner's knowledge, and that the Owner will file an amended certification of payment and pay the additional fee if OWner requests an increase in the number of dwelling units or square footage after the building permit is issued or if the initial determination of units or square Signature, ~....,,____•_,,~'+-~~---------Date: 1., ~-/ { Page 1 of 2 B-34 Rev. 03/09 footage is found to be incorrect, and that (2) the Owner is the owner/developer of the above described project(s), or that the person executing this declaration is authorized to sign on behalf of the Owner. SCHOOL DISTRICT SCHOOL FEE CERTIFICATION (To be completed by the school district(s)) *************************************************************************************************** THIS FORM INDICATES THAT THE SCHOOL DISTRICT REQUIREMENTS FOR THE PROJECT HAVE BEEN OR WILL BE SATISFIED. SCHOOL DISTRICT: The undersigned, being duly authorized by the applicable School District, certifies that the developer, builder, or owner has satisfied the obligation for school facilities. This is to certify that the applicant listed on page 1 has paid all amounts or completed other applicable school mitigation determined by the School District. The City may issue building permits for this project. SIGNATURE OF AUTHORIZED SCHOOL DISTRICT OFFICIAL TITLE NAME OF SCHOOL DISTRICT CMtSSAD. Q9200i DATE ~ju PHONE NUMBER 8-34 Page 2 of 2 Rev. 03/09