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*.SNIA <br />NA,ffi <br />Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (lvl.19) <br />Santa Ana. CA92702 <br />(714) 647.s800 <br />www.santa.ana.org <br />RESIDENTIAL <br />PHOTOVOLTAIC <br />CHECKLIST <br />Solar Photovoltaic (PV) Checklist for Detached SINGLE FAMILY RESIDENCES Only <br />lnstructions: The licensed contractor of record sha I complete all sections, answer the ten questions and <br />s gn the certificatlon section below. A copy of this forrn shall be attached to each of.TV/O sets of pians, of <br />minimunr 11'x 17'size lf answerinq NO to anv of the questions . olan check shall be required <br />Project Address:\C-lz3 rOid-root- L av'''2- <br />Contractor Company Name: Q\rtr1 RVn <br />Contractor Licens e N umber: <br />YES NO <br />S \k <br />I.Q tr <br />,EE <br />Are the following applicable to the proposed project? <br />U/ill the PV system layout provide the required three-foot wide clear access pathways <br />per Section 605.1'1 of the California Fire Code, and is this shown on the roof plan? <br />\ /ill the PV system be instal{ed on a roof having only one roofing layer with no <br />overlays? <br />V/ill the PV array be flush mounted to the existing roof so that the plane of the <br />modules (panels) are parallel to the plane of the roof? <br />U/ill the PV system welgh maximum 4 pounds per square feet or less? <br />\ /ill the PV system be installed where the modules do not overhang any roof edges <br />(such as eaves, gabled ends, ridges and hips)? <br />\ /ill the PV system be installed with a space of 2" minimum to 10" maximum betreen <br />the underside of modules and the surface of the roof? <br />S/ill the PV system be installeC without using any ballast system or counter-weight <br />systeftr? <br />U/ill 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 />S/iil the minimum 5/16" lag screws be installed with a minimum of 2-1/2 inch <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 manufacturer's PV support information.) <br />2 <br />3 <br />6 <br />7 <br />4 <br />5 <br />|g'-_tr <br />tr <br />I <br />tr <br />ULtr <br />f,u <br />Mu <br />8 <br />I <br />10 <br />I certify under penalty of perjury under the laws of the State of California thal t <br />Print Name Kc/v'l(Sa 6.!SSellqqq tqT-levqPhone Number <br />Email Address:(vnRUn -CC'n^ <br />72 t\q <br />Rev 1l/19i2015 <br />(C.lv-\ C(c,^ . t- veQq11 @ <br />l<{ <br />above is true: <br />Slgnature. <br />Date