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Eugene Water & Electric Board

Energy Management Services EWEB Solar Electric Program


500 E 4th Avenue / PO Box 10148 2009 Residential Net Metered System Application
Eugene, OR 97440
541-484-1125 www.eweb.org

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 Taxpayer ID Number: F Employer Identification Number


Information F Social Security Number

Company/Name Check appropriate box: F Individual/Sole Proprietor F Corporation F Limited Partnership F LLC
F Government F Non-Profit Corporation F General Partnership F Other

Attention Phone
____________________________________________________________________________________________________
Mailing Address F Check if same as above (All payments will be sent to this address)

City 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:

Residential Net Metered_Application 2009.doc 2/11/2009 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: Watts (From CEC)

Inverters: Make and Model:


(must be California Energy Commission (CEC) rated)
Quantity: Power Rating: Voltage: CEC Weighted Efficiency:
Single Phase † Three Phase †
Batteries (if applicable): Make and Model:
Quantity: Voltage: Total Amp/hour Rating:
System Site Information
Orientation: Module tilt from horizontal:
Type of Mount: 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 Watts x = Watts
# of modules PTC rating inverter efficiency rating 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 %= % Total Solar Resource Fraction (TSRF)
A minimum of 85% TSRF is required to qualify for this program.

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