Residential Net Metered App

Eugene Water & Electric Board Energy Management Services 500 E 4th Avenue / PO Box 10148 Eugene, OR 97440 541-484-1125 www.eweb.org

EWEB Solar Electric Program 2009 Residential Net Metered System Application

Applicant Information Owner: Owner/Owner’s Representative:

Phone:

Installation Address: Mailing Address: EWEB Billing Account Number: Contact Person:

Phone:

(If different than Owner)

Project Information Start Date:

Estimated Completion Date:

New Facility †

Existing Facility †

Contractor Information Solar Contractor Name:

Phone:

Contact Person:

Cell Phone:

Electrical Contractor Name:

Phone:

Contact Person:

Cell Phone:

Incentive Payment Designee: Payee W-9 Information

Taxpayer ID Number:

Company/Name

Check appropriate box:

Attention

F Employer Identification Number F Social Security Number

F F

Individual/Sole Proprietor Government

F

F

Corporation

Non-Profit Corporation

F F

Limited Partnership General Partnership

F F

LLC Other

Phone

____________________________________________________________________________________________________ Mailing Address

F Check if same as above

City

(All payments will be sent to this address) State

Zip

The following items must accompany this application. 1. Copy of Contract Proposal 4. Site sunchart 2. Detail of system components 5. Property site sketch or drawing. Indicate location of electric meter and 3. Single line electrical drawing disconnect switch. (Applicable permit drawing may be used.) Return all documents to: EWEB Energy Management Services, P.O. Box 10148, Eugene, OR 97440

I, the owner/occupant of the above facility, have reviewed both pages of this application and agree it is correct and accurately represents the solar electric system I intend to install. Also, I agree that I am authorized to install said solar system at this facility. Applicant Name (Print)

EWEB Use Only

Applicant Signature

Date Received:

Residential Net Metered_Application 2009.doc 2/11/2009

Date

EWEB Rep: Page 1 of 2

Detailed System and Site Information (To be completed by Contractor, or Customer if self-installed)

System Description System DC Nameplate Size:

Watts

PV Modules: Make and Model: (must be California Energy Commission (CEC) rated) Quantity: PVUSA Test Condition (PTC) Rating: Inverters: Make and Model: (must be California Energy Commission (CEC) rated) Quantity: Power Rating: Single Phase † Three Phase † Batteries (if applicable): Make and Model: Quantity:

Watts (From CEC)

Voltage:

Voltage:

CEC Weighted Efficiency:

Total Amp/hour Rating:

System Site Information Orientation: Type of Mount:

Module tilt from horizontal: Roof †

Pole †

Ground †

If roof mounted, in the space below describe roofing material and approximate remaining life of the roof:

Estimate of System Output and Performance System Output: x # of modules

Watts x PTC rating

= inverter efficiency rating

Watts system AC output Watts

Site Performance Factors: Solar Resource available after shading losses:

%

(from Eugene sunchart)

Solar Resource available after tilt & orientation losses:

% (from Eugene sunchart, relative to optimal location of modules)

Shading losses % x tilt & orientation losses %= A minimum of 85% TSRF is required to qualify for this program.

% Total Solar Resource Fraction (TSRF)

Note: If power conditioning equipment is part of the system, additional loss calculation factors may apply.

Residential Net Metered_Application 2009.doc 2/11/2009

Page 2 of 2