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*,,SNTA <br />NA,ffi <br />Planning & Building Agency <br />Building Safety Division <br />20 Civic CEnter Plaza <br />P.O. Bor 1988 {M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www.santa-ana.org <br />RESIDENTIAL <br />PHOTOVOLTAIC <br />CHECKLIST <br />Solar Photovoltaic (PV) Checktist for Oetached STNGLE FAMILy RESIDENCES Only <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 />minimLrm 1l'x 17 size lf ans wenn NO to an of the o uestions. Dla n check sha ll be required <br />Project Add ress 22I 3 CROVEMONT ST, SANTA ANA, CA 92705 <br />Contractor Company NAME: FREEDOM FOREVER <br />Contractor License Number: C-10 *1029644 <br />YES NO Are the following applicable to the proposed proiect? <br />Will 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 />Will the PV system be installed on a roof havjng only one roofing layer with no <br />overlays? <br />U/ill the PV array be flush mounted to the existjng roof so that the plane of the <br />modules (panels) are parallel to the piane of the roof? <br />\ /ill the PV system weigh maxirnum 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 />Vvill the PV system be installed with a space of 2" minimum to l0" maximum between <br />the underside of modules and the surface of the roof? <br />Will the PV system be installed without using any balast 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 />\y'/ill the minimum 5/16" lag screws be insta ed with a minimum ot ?-112inch <br />embedment into roof rafters (with pre-ddlted hotes) and ts this minimum embedment <br />shown on the plans? <br />Are ALL the structural pages of the piaos stamped and srgned by a California <br />licensed professional engineer? (including project speciflc site plan, pV layout, <br />anchorage spacing, anchorage details and manufacturer's PV support information.) <br />El U <br />2 Eltr <br />trtr <br />Etr <br />trtr <br />EQ <br />Etr <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 Eltr <br />9 Etr <br />10 EItr <br />I certify und <br />Print Name <br />enalty of perjury under the laws of the State of California that the above is true <br />S ig n 61ure. <br />Phone Number: 95 t -239_029 <br />Email Address: karbuckletDtieedorntb <br />Rev 1l/19/2015 <br />rever.com <br />Date: