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Energy Design Assistance Application

  • Enter as much information that is known at this time; the rest can be entered later.
  • Fields marked with a red bar are required.
  • After entering information, click the “Submit” button at the bottom of the page to save your progress.
  • Once the information is submitted, you will receive a link via email that can be used to access the form again, or forwarded to others to complete more of the application.
Application
Energy Design Assistance
Created 6/24/2021 9:22:46 AM
Your Information
Project
BUSINESS CUSTOMER INFORMATION

Please ensure all contact information is correct, as all rebate checks will be sent to this address.

Company Name:
Billing Address:
City:
State:
ZIP:

Customer Contact

Name:
Phone:
E-mail:

Alternate Recipient

Name:
Address:
City:
State:
ZIP:
Phone:
E-mail:

Customer Utility Account Manager

CUSTOMER'S DESIGN TEAM INFORMATION

Please fill out the name, contact, phone and e-mail address for each of the following:

Architectural Firm

Name:
Contact:
Phone:
E-mail:

General Contractor

Name:
Contact:
Phone:
E-mail:

Mechanical Engineer

Name:
Contact:
Phone:
E-mail:

Electrical Engineer

Name:
Contact:
Phone:
E-mail:

Development Company

Name:
Contact:
Phone:
E-mail:

Other Design Team

Name:
Contact:
Phone:
E-mail:
CERTIFICATION INFORMATION
Are you planning on obtaining a green building certification (3rd party verification)?
ENERGY DESIGN ASSISTANCE APPLICATION: SCREENING FORM

Schematic Design

Start Date:
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End Date:
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Notes on Schedule:

Design Development

Start Date:
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End Date:
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Notes on Schedule:

Architectural Construction Documents

Start Date:
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End Date:
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Notes on Schedule:

M/E Construction Documents

Start Date:
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End Date:
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Notes on Schedule:

Construction Schedule

Start Date:
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End Date:
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Notes on Schedule:

Design Process


Building Information

Does this square footage include multi-tenant/lease type spaces?

Heating and Cooling






DESIGN CONSIDERATIONS OPTIONS

Willingness to Consider Energy Saving Alternatives

HVAC system alternatives:
If yes, describe the alternative systems:
Orientation-building layout
Wall/roof insulation:
Glazing type-window design:
Lighting design/controls:
HVAC efficiency/controls:
Demand response strategies:
On-site renewables:
Electric vehicle charging stations:
Energy efficiency financing opportunities:
Special considerations and other comments:


How did you hear about the Energy Design Assistance program?
select

Signature
Customer Authorized Signatory: Authorized signer (please type full name)

Date:
Design Team Authorized Signatory: Authorized signer (please type full name)
Date:
Note: Clicking the 'Submit' button will notify program administrators for further action, but does not finalize this application.
Upon submission you will receive an email confirmation that will include a link to allow you to make further modifications.