Renewable Systems Rebate

Weatherwise Service Renewable Energy System Rebate Application

Three Easy Steps To Apply

1. Complete the Rebate Application. Be sure to

answer all sections of the application and sign and date it.

2. Mail the Rebate Application to:

Weatherwise Service P. O. Box 1150 Port Angeles, WA 98362

3. If your application is approved the City will issue you a Notice to Proceed by mail.

Phone: 360-417-4718 FAX: 360-417-4709 Email: [email protected]

Please complete all the requested information on pages 2 and 3. See page 4 for information on eligibility requirements and Solar Systems Material and Installation Specifications. Please complete all requested information on your home or business: Building Owner’s Name: Mailing Address: Port Angeles Service Address: Utility Account Number:

Home Phone:

Work Phone:

Please check the box that most closely represents the primary heating system you currently have: Zonal electric (baseboard, ceiling cable, etc.) Fuel oil, propane or natural gas Electric forced air with w/o air conditioning Wood stove or fireplace insert Electric heat pump Please check the box that most closely represents the type of water heater you currently have: Electric Propane Other (please explain)_______________________________________ Please check the box that most closely represents your home: Site-built home Manufactured home Multi-family home Commercial Historical Preservation Notice The Owner is required to comply with the Washington State Historic Preservation Code. Buildings that are at least 45 years old may be eligible for listing on the National Register of Historic Places and the Washington Heritage Register. To receive nomination forms and instructions, please contact the Washington State Department of Archaeology and Historic Preservation at (360) 586-30654 or visit their website at: www.dahp.wa.gov. To the best of your knowledge is your building listed in the National Register of Historic Places or the Washington Heritage Register? Yes No Not Applicable

Phone: 360-417-4718 FAX: 360-417-4709 Email: [email protected]

Please complete all requested information on proposed renewable energy system: Installer Information: Installer: Installer Phone Number: Installer Address: The Bright Way To Heat WaterTM Certified Installer: Yes□ No □ Solar Water Heating System Solar Water Heating System Type of Solar Water Heater installed Manufacturer: ____________________________ Single tank: _____ Double tank _____ Model #: ________________________________ Three tank: _____ Collector Size: ____________________ Sq. Ft. Antifreeze: _____ Drain back: _____ Collector Tilt: _____________________ degrees Back-up electric water heater information: Collector orientation: _______________ degrees Size (gal): _____ Energy Factor: _____ Collector orientation: E or W of true South Permits: building □ electrical □ other □ Price including permits: $ Photovoltaic System Photovoltaic Module: DC AC Inverter: Manufacturer: ____________________________ Manufacturer: ____________________________ Model #: ________________________________ Model #: ________________________________ Number of Modules: ______________________ Power Rating of Inverter:_________________ Power Rating per Modules:_________________ Location of Protective Total Rated Output: _______________________ Equipment:_______________________________ Description of Protective Equipment:__________________________________ ____________________________________________ ____________________________________________ Net Metering Agreement Submitted to City Electrical Department: Yes□ No □ Permits: building □ electrical □ other □

Price including permits:

$

Total Price:

$

Phone: 360-417-4718 FAX: 360-417-4709 Email: [email protected]

Rebate Eligibility Requirements Rebates are available for qualifying renewable energy systems installed after October 1, 2007 and completed and passed inspection by August 31, 2009. Only renewable systems that have been

approved in writing by a Weatherwise Service representative qualify for a rebate. The participating customer must be the owner of the property or the owner's legally assigned representative Service Requirements: To be eligible for a rebate from the City of Port Angeles your home must currently be served electricity by the City of Port Angeles. To be eligible for a Solar Water Heater rebate your domestic hot water must currently be provided by an electric water heater. Rebates are only available for new equipment. Photovoltaic Systems: Solar photovoltaic systems must be installed per Port Angeles Municipal Code 13.10.065 – Net Energy Metering and in accordance with the Solar Photovoltaic General Provisions of the City’s Weatherization Material & Installation Specifications. Solar Water Heating System: Solar water heating systems must be installed per THE BRIGHT WAY TO HEAT WATERTM general program specifications by a certified installer. Weatherization Material and Installation Specifications: A complete copy of the City’s Weatherization Material & Installation Specifications is available on the CONSERVATION pages of the City’s website www.cityofpa.us. You can also request a copy on the Conservation phone line at 360-417-4713. The Brightway To Heat Water: A complete copy of the THE BRIGHT WAY TO HEAT WATERTM general program specifications is available on the CONSERVATION pages of the City’s website www.cityofpa.us. You can also request a copy on the Conservation phone line at 360-417-4713. Inspection notification: All renewable energy systems installations must satisfactorily pass inspection by a Weatherwise Service representative prior to rebate payment. All installations may include an additional inspection by a Bonneville Power Administration Representative. The Owner(s) read, understood and agreed to comply with the Rebate Application and the City’s Material & Installation Specifications and THE BRIGHT WAY TO HEAT WATERTM General Program Specifications. By signing below the Owner(s) certifies the information provided in the application is complete, true, and correct.

Owner Acceptance

Date

Owner Acceptance (if more than one Owner)

Date

Phone: 360-417-4718 FAX: 360-417-4709 Email: [email protected]