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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: Installation Address: Mailing Address: EWEB Billing Account Number: Contact Person:
(If different than Owner)

Phone:

Phone:

Project Information
Start Date: New Facility Estimated Completion Date: Existing Facility

Contractor Information
Solar Contractor Name: Contact Person: Electrical Contractor Name: Contact Person: Phone: Cell Phone: Phone: Cell Phone:

Incentive Payment Designee:
Payee W-9 Information Taxpayer ID Number:
Employer Identification Number Social Security Number

Company/Name

Check appropriate box:

Individual/Sole Proprietor Government

Corporation

Limited Partnership General Partnership

LLC Other

Non-Profit Corporation Phone

Attention Mailing Address City Check if same as above

____________________________________________________________________________________________________
(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) Applicant Signature Date

EWEB Use Only

Date Received:

EWEB Rep:
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Residential Net Metered_Application 2009.doc 2/11/2009

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

System Description
System DC Nameplate Size: 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: Voltage: Watts

Watts (From CEC)

Voltage:

CEC Weighted Efficiency:

Total Amp/hour Rating:

System Site Information
Orientation: Type of Mount: Roof Pole Module tilt from horizontal: 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 PTC rating

Watts x
inverter efficiency rating

=

Watts system AC output Watts

Site Performance Factors: Solar Resource available after shading losses: Solar Resource available after tilt & orientation losses: Shading losses % x tilt & orientation losses %= A minimum of 85% TSRF is required to qualify for this program. %
(from Eugene sunchart)

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

% 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

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