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Planning & Building Agency <br />Building Saf€ty Division <br />20 Civic Centor Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.oag <br />Project Add ress:22I3 GROVEMONT ST, SANTA ANA, CA 92705 <br />Contractor Company 111266. FREEDOM FOREVER <br />Contractor License Numbor: C l0 t 1029644 <br />RESIDENTIAL <br />PHOTOVOLTAIC <br />CHECKLIST <br />YES NOtrtr <br />Etr <br />Etr <br />Btrtro <br />8tr <br />EID <br />trtr <br />EItr <br />EItr <br />I <br />'10 <br />R€v 1l/19/2015 <br />2 <br />3 <br />Are the following applicable to the proposed proiect? <br />Will lhe 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 />Will the PV system be installed on a roof having only one roofing layer with no <br />overlays? <br />Will the PV anay be flush mounted to the existing roof so that the plane of the <br />modules (panels) are parallei 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 't0" maximum between <br />the underside of modules and lhe surface of the roof? <br />Will lhe 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 />Wll 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 California <br />licensed professional engineer? (including project specific site plan. PV layout, <br />anchorage spacing, anchorage details and manufacturer's PV support information.) <br />nalty of periury under the laws ot the State of California that the above is true <br />Signat <br />4 <br />5 <br />6 <br />7 <br />8 <br />I corlify und <br />Print Name <br />Phone Number: g5l -239-() <br />Email Address: karbuckletafreedomfbrever.com <br />*,,SAN[A <br />NAJ}ffi <br />Solar Photovoltaic (PV) Checklist for Oetached STNGLE 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 ptans, of <br />minimum 11" x 17"size. lf answerino NOtoanvof the questions, olan check shall be reouired.