CITY OF SAN CLEMENTE
RESIDENTIAL AND NON-RESIDENTIAL
CHECKLIST FOR PERMITTING ELECTRIC VEHICLES
AND ELECTRIC VEHICLE SERVICE EQUIPMENT (EVSE)
Job Address: Permit No.
☐Single-Family ☐Multi-Family (Apartment) ☐Multi-Family (Condominium) ☐Commercial (Single Business) ☐Commercial (MultiBusinesses) ☐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:
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.
Exhibit A
Applicant Name:
Applicant Phone & email:
Contractor Name: License Number & Type:
Contractor Phone & email:
Owner Name:
Owner Phone & email:
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)
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 Permit Applicant: ____________________ Date: _______________