CITY OF FORTUNA
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING AND SAFETY DIVISION
621 11th Street, Fortuna, California 95540
Phone: (707)725-7600 Fax: (707)725-7610
RESIDENTIAL AND NON-RESIDENTIAL
CHECKLIST FOR PERMITTING ELECTRIC VEHICLE CHARGING STATIONS Please complete the following information related to permitting and installation of Electric Vehicle Charging Station (EVCS) as a supplement to the application for a building permit. This checklist contains the technical aspects of EVCS installations and is intended to help expedite permitting and use for electric vehicle charging.
Upon this checklist being deemed complete, a permit shall be issued to the applicant. However, if it is determined that the installation might have a specific adverse impact on public health or safety, additional verification will be required before a permit can be issued. This checklist substantially follows the “Plug-In Electric Vehicle Infrastructure Permitting Checklist” contained in the Governor’s Office of Planning and Research “Zero Emission Vehicles in California: Community Readiness Guidebook” and is purposed to augment the guidebook’s checklist Submittal Date:
Project Applicant: Phone:
Email:
Property Owner: Phone:
Email:
Project Address: APN:
Contractor: Phone: Email:
Contractor Address:
Project Description:
☐ Single-Family ☐ Multi-Family (Apartment) ☐ Multi-Family (Condominium) ☐ Commercial (Single Business) ☐ Commercial (Multi-Businesses) ☐ Mixed-Use ☐ Public Right-of-Way
Location and Number of EVCS to be Installed:
Garage ______ Parking Level(s) _____ Parking Lot _____ Street Curb _____ EVCS Charging Level: ☐ Level 1 (120V) ☐ Level 2 (240V) ☐ Level 3 (480V) Maximum Rating (Nameplate) of EV Charging Station = ___________ kW Voltage EVCS= V
Mounting of EVCS: ☐ Wall Mount ☐ Pole Pedestal Mount ☐ Other _____________ Specify Either Connected, Calculated or Documented Demand Load of Existing Panel:
Connected Load of Existing Panel Supplying EVCS = __________ Amps Calculated Load of Existing Panel Supplying EVCS = __________ Amps Demand Load of Existing Panel or Service Supplying EVCS = _________ Amps (Provide Demand Load Reading from Electric Utility)
Total Load (Existing plus EVCS Load) = __________ Amps
For Single Family Dwellings, if Existing Load is not known by any of the above methods, then the Calculated Load may be estimated using the “Single-Family Residential Permitting Application Example” in the Governor’s Office of Planning and Research “Zero Emission Vehicles in California: Community Readiness Guidebook” https://www.opr.ca.gov
EVCS Rating ________Amps x 1.25 = ___Amps = Minimum Ampacity of EVCS Conductor = # AWG For Single-Family: Size of Existing Service Conductors = # __________ AWG or kcmil OR
Size of Existing Feeder Conductor
Supplying EVCS Panel = # __________ AWG or
OR
Kcmi (or Verify with Inspector in field)
I hereby acknowledge that the information presented is a true and correct representation of existing conditions at the job site and that any causes for concern as to life-safety verifications may require further substantiation of information.
_______________________ ________________________ ____________
PRINT NAME SIGNATURE DATE