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*,,SANTA <br />NA-"'iltr <br />Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, C492702 <br />(714) 647-s800 <br />www.santa-ana.org <br />si -11 a:::t l <br />Solar Photovoltaic (PV) Checklist for Detached SINGLE FAMTLY RESTDENCES Onty <br />lnstructions: The licensed contractor of record shall complete all sections, answer the ten questions and <br />sign the certiflcation section below. A copy of this form shall be attached to each of TWO sets of plans, of <br />minimum 11" x 17" size. lf answerino NO anv of the ouestions. olan chec k s hall be required. <br />RESIDENTIAL <br />PHOTOVOLTAIC <br />CHECKLIST <br />P roj ect Address: 3Z I ,E - Vre --,p>A, 4u€ Sz rrz- <br />Contractor Company Name: <br />Contractor License Number: <br />Ee.:>^/a ? L:z?rs,tta <br />YES NO <br />1 Eltr <br />,-&tr <br />3.8 tr <br />4 EJ <br />5 -Eltr <br />6 Eltr <br />? Etr <br />eEtr <br />g -"El tr <br />10 )El E <br />Are the following applicable to the proposed project? <br />Will the PV system layout provide the required three-foot wide clear access pathways <br />per Section 605.'11 of the California Fire Code, and is this shown on the roof plan? <br />Will the PV system be installed on a roof having only one roofing layer with no <br />overlays? <br />Will the PV array be flush mounted to the existing roof so that the ptane of the <br />modules (panels) are parallel to the plane of the roof? <br />Will the PV system weigh maximum 4 pounds per square feet or less? <br />Will the PV system be installed where the modules do not overhang any roof edges <br />(such as eaves, gabled ends, ridges and hips)? <br />Will the PV system be installed with a space of 2" minimum to 10" maximum between <br />the underside of modules and the surface of the roof? <br />Will the PV system be installed without using any ballast system or counter-weight <br />system? <br />Will the anchors be installed with a maximum horizontal anchor spacing of 6 feet <br />and is this maximum horizontal spacing shown on the plans? <br />Will the minimum 5/16" lag screws be installed with a minimum ol2-112 tnch <br />embedment into roof rafters (with pre-drilled holes) and is this minimum embedment <br />shown on the plans? <br />Are ALL the structural pages of the plans stamped and signed by a California <br />licensed professional engineer? (including project specific site plan, PV layout, <br />anchorage spacing, anchorage details and manufa ppo nformation.) <br />I certify under penalty of perjury under the laws of the State forn <br />Signature <br />Phone Number (;zu) 2al- 3 t8., <br />print Name: '7r.-r - //z,-,-.>=arJ <br />Date: -- <br />Email Address: 1-E Z tu,-.-_r=ry 1-=Z-D. c,-.('\.,'c^ <br />veisl <br />Rev 11/19/2015 <br />Ez€r\/€.2-c>