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2. Building Information
4. Building Address*
6. Major Cross Streets*
10. Applicant Information
12. Applicant Name*
13. Company Name (if applicable)
15. Applicant Address*
17. Applicant Phone Number*
18. Applicant Email*
22. Contractor Information
24. Contractor Name
25. Contractor License Number
27. Contractor Address
31. Owner Information
33. Owner Name*
34. Owner Phone Number*
36. Owner Address*
40. Additional Information
42. Valuation for Mounting Only*
    Cost of Job - U.S. Dollars
43. Kilowatt (KW) of System*
45. Number of Modules*
47. Is there an existing PV system on the roof?

    1. Yes
    2. No
48. If yes, how many modules?
50. Panel Upgrade
    -- Select One --YesNo
51. If Yes, What Amperage?
53. Separate Permit
    -- Select One --YesNo
54. Roof or Ground Mount?
    -- Select One --Roof MountGround Mount
56. ****If any of the following information applies to your project, all documentation and plans submitted to Building and Safety for plan check must first have Los Angeles County Fire Department approval PRIOR to submitting this application to the Building and Safety Division.
58. ****BUILDING INTEGRATED PV/ENERGY STORAGE SYSTEMS (ESS) - 3 KWH AND ABOVE:
60. Number of ESS Units
61. Total ESS KWH
62. Total square footage of Building Integrated Photo Voltaics (BIPV)
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field