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Planning & Building Agancy <br />Buildang Safety Division <br />20 Civic Canter Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 6rf7-5800 <br />klfw.santa-ana.org <br />RES!DENTIAL <br />PHOTOVOLTAIC <br />CHECKLIST <br />Solar Photovoltaic 1ev) Ctre&list for Detached SINGLE FAMILy RESTDENCES Only <br />soL{1 cBC 2013 <br />licensed conhactor of record shall complete all sections, answer the ten questions and <br />n section below. A copy of this form shall be attached to each of TWO sets of plans, of <br />size.tf no NO to of the . olan c shall be ired,jOE \^.J d-^,ad <br />lnstructions: The <br />sign the certificatio <br />minimum 11" x 17" <br />Project Address: <br />2 <br />Contractor Company Name: <br />Contractor Lioense Number: <br />10.tr D <br />o e-v' <br />q 7> <br />Are the following applicable to the proposed proiect? <br />ruryill the PV system layout provide the required thre+.foot wide clear access pathways <br />per Section 605.'11 of the Califomia 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 />ovedays? <br />Will 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 />Will the PV system weigh maximum 4 pounds per square feet or less? <br />Will the Pl/ 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 />Wifl the minimum 5/16" lag screws be installed,with a minimum of 2-112 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 Califomia <br />licensed professional engineer? (including project specific site plan, pV layout, <br />anchorage spacing, anchorage details and manufacture/s pV support inf6rmation.) <br />I certify under penalty of perjury under the laws of the State of Cal the above is true: <br />Print Name:Signature: <br />YES tilo <br />Etr <br />\n <br />\a\o <br />Na <br />tra <br />qtr <br />4. <br />5 <br />6 <br />7 <br />8 <br />9 <br />tltr <br />trtr <br />\-\ V1 \-!CL <br />Phone Number: <br />Email Address: <br />Date: IL <br />o <br />Rev: 11/19/2015 <br /><lg <br />l( a^_ <br />\zrD <br />- <br />-,-SANTA <br />ANA,','i,i}tr <br />1