Rebate + Loan post-purchase form - LIVE Header Image
OBF?
Application received date
:  

Appliance Rebate Application Form

Congratulations on your electrification project! Before staring your rebate application, please make sure you have the following documents ready. 

  1. Itemized paid contractor invoice 
  2. Photos of new equipment installed, and photo of capped gas line 
  3. Building permit for your upgrade(s) signed by City Inspector 

Note that all the questions with a red asterisk (*) by them are required. Questions without it are optional. 

Our team will review your rebate application and get back to you within 7 business days. Our emails will come from programs@peninsulacleanenergy.com. If you haven't heard from us in this timeframe, please check your spam mailbox. 

Zero Percent Loan & Appliance Rebate Post-Installation Form

Dear Contractor, 

This form serves as both the Peninsula Clean Energy rebate application form and Zero Percent Loan program post-installation project verification form. 

Here are all the documents you will be required to upload for the upgrades completed: 

  1. The Final Project Verification & Loan Terms Form signed the by Customer and Contractor 
  2. Itemized paid contractor invoice 
  3. For heat pump water heater installations 
    1. Photo of installed heat pump water heater
    2. Proof gas equipment decommissioning (e.g. photo of capped gas line or photo of capped gas meter if home fully electric)
    3. Building permit 
  4. For heat pump HVAC installations 
    1. Photo of installed heat pump HVAC system
    2. Proof of decommissioning (e.g. photo of capped gas line or photo of capped gas meter if home fully electric)
    3. Building permit 
  5. For panel upgrades 
    1. Photo of the inside of the new panel
    2. Building permit 

Our team will review the documents within 3-5 business days and let you know when payment processing has begun. You will be paid for rebates the project is eligible for and the loan amount the customer financed. If you have any questions, email us at programs@peninsulacleanenergy.com 

Applicant Information

Applicant Information

Name*
Property address*
Please confirm you are the owner of this property. *
Is your mailing address the same as your property address?*
Mailing address*

Project Information

What upgrades did you complete? Select all that apply.*
What upgrades did you complete? Select all that apply.
What energy efficiency and weatherization work did you complete?
Did you install a combination water and space heating system (i.e. a single system that provides both)?*
Examples of this include a Harvest Thermal system.
If you did not use a contractor and completed the project yourself, please write in "DIY".
When was your project installed?*

Heat Pump Water Heater Information

Equipment Type - HPWH
Equipment Type Detail - HPWH
What fuel source did your previous water heater use?*
Was your previous water heater a storage tank water heater or a tankless water heater?*
Heat pump water heater manufacturer*
Is your heat pump water heater 120v (standard outlet) or 240v?
Is your heat pump water heater wifi/grid enabled?
Total cost includes equipment and labor. Please do not factor in rebates or cost for panel upgrades, if any.

Heat pump HVAC Information

Equipment Type - HVAC
Previous fuel type
What kind of gas heater/furnace did you previous have?*
Did you have central air conditioning (AC) before your heat pump installaton?*
What type of heat pump HVAC system did you install?*
Heat pump manufacturer*
Is your HVAC system 120v (standard outlet) or 240v?
Is your HVAC system wifi/grid enabled?
Total cost includes equipment and labor. Please do not factor in rebates or cost for panel upgrades, if any.

Panel Upgrade Information

Equipment Type - Panel
This is the Measure record type.
Electrical panel yes checkbox for PP
What type of electrical panel upgrade did you complete?*
Total cost includes equipment and labor. Please do not factor in rebates.
Equipment Type - Thermostat
This is the Measure record type.
This is the Measure record type.
This is the Measure record type.
This is the Measure record type.
This is the Measure record type.

Supporting Documents

Please upload the following documents for the upgrades you completed below. You could upload everything in a single file or you can upload them individually. Each upload button below will only allow you to upload 1 file, so we included multiple upload buttons in case you plan to upload them individually. 

  1. Itemized paid contractor invoice 
  2. For heat pump water heater installations 
    1. Photo of installed heat pump water heater
    2. Proof gas equipment decommissioning (e.g. photo of capped gas line or photo of capped gas meter if home fully electric)
    3. Building permit 
  3. For heat pump HVAC installations 
    1. Photo of installed heat pump HVAC system
    2. Proof of decommissioning (e.g. photo of capped gas line or photo of capped gas meter if home fully electric)
    3. Building permit 
  4. For panel upgrades 
    1. Photo of the inside of the new panel
    2. Building permit 

Please upload the following documents for the upgrades you completed below. You could upload everything in a single file or you can upload them individually. Each upload button below will only allow you to upload 1 file, so we included multiple upload buttons in case you plan to upload them individually. 

Here are all the documents you will be required to upload for the upgrades completed: 

  1. The Final Project Verification & Loan Terms Form signed the by Customer and Contractor 
  2. Itemized paid contractor invoice 
  3. For heat pump water heater installations 
    1. Photo of installed heat pump water heater
    2. Proof gas equipment decommissioning (e.g. photo of capped gas line or photo of capped gas meter if home fully electric)
    3. Building permit 
  4. For heat pump HVAC installations 
    1. Photo of installed heat pump HVAC system
    2. Proof of decommissioning (e.g. photo of capped gas line or photo of capped gas meter if home fully electric)
    3. Building permit 
  5. For panel upgrades 
    1. Photo of the inside of the new panel
    2. Building permit
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.

Household and Demographic Information

Please note that your answers to these questions will be kept confidential and do not impact your application in any way. Your responses will be anonymously combined with those from other applicants to help Peninsula Clean Energy understand electrification adoption among Peninsula Clean Energy customers. These questions are all optional. 

Number of people residing in your home.
What is your annual household income?
What is your age?
What is your gender?
What is your race/ethnicity? (select all that apply)
Save and Resume Later
Progress
Powered by Formstack Create your own form