C i t y o f H e s p e r i a
BUILDING AND SAFETY DIVISION
240715-BS-XX EV Charging Check List
Residential and Non-Residential Checklist for Permitting Electric Vehicles and Electric Vehicle Service Equipment (EVSE)
Please complete the following information related to the permitting and installation of Electric Vehicle Service Equipment (EVSE) as a supplement to the application for a building permit. This checklist contains the technical aspects of EVSE installations and is intended to help expedite the 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 per mit 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.
Job Address: Permit No.
☐ Single-Family ☐ Multi-Family (Apartment) ☐ Multi-Family (Condominium) ☐ Commercial (Single Business) ☐Commercial (Multi-Businesses) ☐ Mixed-Use ☐ Public Right-of-Way
Location and Number of EVSE to be Installed:
Garage ______ Parking Level(s) _____ Parking Lot _____ Street Curb _____ Description of Work:
Attachment 3
C i t y o f H e s p e r i a
BUILDING AND SAFETY DIVISION
240715-BS-XX EV Charging Check List
Applicant Name:
Applicant Phone Number & E-mail:
Contractor Name: License Number & Type:
Contractor Phone Number & E-mail:
Owner Name:
Owner Phone Number & E-mail:
EVSE Charging Level: ☐ Level 1 (120V) ☐ Level 2 (240V) ☐ Level 3 (480V) Maximum Rating (Nameplate) of EV Service Equipment = kW Voltage EVSE = V Manufacturer of EVSE:
Mounting of EVSE: ☐ Wall Mount ☐ Pole Pedestal Mount
☐ Other
System Voltage:
☐ 120/240V, 1ϕ, 3W ☐ 120/208V, 3ϕ, 4W ☐ 120/240V, 3ϕ, 4W ☐ 277/480V, 3ϕ, 4W ☐ Other
Rating of Existing Main Electrical Service Equipment = Amperes Rating of Panel Supplying EVSE (if not directly from Main Service) = Amps Rating of Circuit for EVSE: Amps / Poles
AIC Rating of EVSE Circuit Breaker (if not Single Family, 400A) = A.I.C. (or verify with Inspector in field)
C i t y o f H e s p e r i a
BUILDING AND SAFETY DIVISION
240715-BS-XX EV Charging Check List
Specify Either Connected, Calculated, or Documented Demand Load of Existing Panel:
• Connected Load of Existing Panel Supplying EVSE = Amps • Calculated Load of Existing Panel Supplying EVSE = Amps • Demand Load of Existing Panel or Service Supplying EVSE = Amps (Provide Demand Load Reading from Electric Utility)
Total Load (Existing plus EVSE 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
EVSE Rating Amps x 1.25 = Amps = Minimum Ampacity of
EVSE Conductor = # AWG
For Single-Family: Size of Existing Service Conductors = # AWG or kcmil - or -: Size of Existing Feeder Conductor
Supplying EVSE Panel = # AWG or kcmil
(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.
Signature of Applicant: Date: