SmartSolar Program: Application

Please fill out this form as thoroughly as possible. This will help us process your application more quickly.

* = required field

Interested in (Control/command + click for multiple selections.):
Solar In GeneralSolar Electric (PV)Solar Hot WaterEnergy Efficiency

I. CONTACT INFORMATION

*Name

Name of Business or Organization (if applicable)

*Address

*City

*Zip

*Main Phone

Work Phone

Cell Phone

*Email

Business Hours

Best Time to Call

Best Time to Visit

*How did you hear about SmartSolar?
This websiteAt an eventSaw a flyerReferred by a friendReferred by a nonprofit organizationReferred by neighborhood or business associationCommunity newsletterNewspaperSaw an advertisement in AlbanyReferred by the City of BerkeleyReferred by the City of El CerritoReferred by the City of EmeryvilleReferred by the City of OaklandReferred by the City of RichmondFound in online searchSaw in online mediaSaw in traditional mediaOther

If other, please explain.

II. PROPERTY INFORMATION

Do you or your business/organization own or lease your property?
 Own Lease

What is the approximate square footage of your property/building?

How many floors are in your building?

Approximately how many occupants does your building have?

Which utilities do you pay for at this property (Control + click for multiple selections.)?
ElectricGasWater

What is your billing rate for electric?
E-1 (standard for residential)EL-1E-6EL-6E-7EL-7EME-19A-1A-6A-10A-10 (TOU)OtherNot sure

What year was your building built?

What is your billing rate for natural gas?
G-1 (standard for residential)GL-1G-NR1G-2NROtherNot sure

Have you conducted an energy audit of your home or facility?
 Yes  No

What is your estimated federal tax rate?

What is your estimated state tax rate?

Have you upgraded your lighting to energy efficient options (fluorescents, CFLs, LEDs, occupancy sensors)?
Yes - 100% Yes - 75% Yes - 50% Yes - 25% No

Are your attic/walls/floors insulated (Control + click for multiple selections.)?
Yes, attic is insulated, R-value of 30+ (or R19 when crawl space is inadequate).Yes, attic is insulated, R-value unknown.No, attic is not insulated.Yes, walls are insulated, R-value 19.Yes, walls are insulated, R-value unknown.No, walls are not insulated.Yes, floors are insulated.No, floors are not insulated.

Which of the following appliances have you upgraded to energy efficient and/or Energy Star models (Control + click for multiple selections.)?
Hot water heater(s)Other heating/cooling equipmentRefrigerator(s)Dishwasher(s)Stove(s)Oven(s)Other kitchen equipmentClothes washer(s)Clothes dryer(s)Computer(s)Television(s)Other electronic equipmentNone of the above

What is your interest level in a low to no cost home performance audit/comprehensive energy audit of your facility?
Very interested, sign me up!Somewhat interested, please send me additional information.Not interested, have already conducted audit/already energy efficient.Not interested, other.

*In what condition is your building's roof?
NewGoodNeeds some repairOldUnknown condition

*What type of material is the roof made of?
CompositeComposite with flashingsEPDM membraneFlat roof with no penetrationsFlat roof with penetrationsFoamHardiShakeHardiSlateMetal corrugatedMetal standing seamMetal tileRolled roofing/torchdownTar and gravel tile concreteTile SpanishTrellisVinyl membraneWood shakeUnknown material

III. CONFIRMATION
To submit this form, please enter the text in the image into the field below.

After you click submit, please check the top or bottom of this page for a message that verifies we received your form.