Ph: (530) 749-3904 Website: www.marysville.ca.us
Fax: (530) 749-3991 Email: [email protected]
City of Marysville
Community Development and Services
Electric Vehicle Charging Station Submittals
Adopted: TBD
Permitting and Installation of Electric Vehicle Service Equipment (EVSE) Checklist
Please complete the following information related to 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 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.
Applicant Information:
Name: Phone Number:
Email Address:
Job Address:
Contractor Information:
Name: Phone Number:
License Number: Classification:
Email Address:
Owner Information:
Name: Phone Number:
Email Address:
Use of Building or Area:
□ Single Family □ Mixed-Use
□ Multi-Family (Apartment) □ Multi-Family (Condominium) □ Commercial (Single Business) □ Commercial (Multi-Business) □ Public Right-of-Way
Location and Quantity of EVSE to be Installed:
□ Garage □ Parking Levels
□ Parking Lot □ Street Curb
EVSE Specifications:
EVSE charging Level:
□ Level 1 (120V) □ Level 2 (240V) □ Level 3 (480V)
Maximum Rating (Nameplate) of EVSE = (kW)
Voltage EVSE = (V) Manufacturer of EVSE =
Mounting of EVSE:
□ Wall Mount □ Pole Pedestal Mount □ 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)
Electrical System Specifications:
Voltage:
□ 120/240 V, 1Ø,3W □ 120/208V, 3Ø,4W □ 120/240, 3Ø, 4W
□ 277/480V, 3Ø, 4W Other:
Electrical System Load Calculation:
Specify Either Connected or Documented Demand Load of Existing Panel:
□ Connected Load of Existing Panel Supply 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 Readiness Guidebook” http://www.opr.ca.gov .
EVSE Electrical Supply Conductor Sizing Calculation:
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
Suze of Existing Feeder Conductor Supplying EVSE Panel = # AWG or kcmil OR
(Verify with Inspector in Field)
EVSE Location and Metering:
Proposed EVSE location may not be located over any underground utility facilities, and equipment, and/or infrastructure. Also, a dedicated meter may be required on any EVSE.
Chapter 18 Code Compliance:
Documentation that the submitted plans and proposed structure are in compliance with Marysville Municipal code Chapter 18.87.
Supplemental Assessment Checklist:
AN Assessment Checklist has been completed and is attached hereto.
Additional Safety and Performance Standards Documentation:
Documentation that establishes that this application and structure contemplated therein meet the applicable safety and performance standards established by the California Electrical Code, the Society of Automotive Engineers, the National Electrical Manufactures Association, and accredited testing laboratories such as Underwriters Laboratories and, where applicable, rules of the Public Utilities Commission regarding safety and reliability.
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. I also acknowledge that nothing herein shall modify or remove my obligation as a permit applicant, owner, or operator of an electric vehicle charging station to comply with any electric utility’s reasonable and feasible safety, reliability, and engineering interconnection policies.
I will ensure that a copy of the equipment specifications and installation guide will be available to the Building Inspector at time of inspection.
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Signature of Applicant & Date