Download commercial / industrial customer information sheet

RESIDENTIAL CUSTOMER INFORMATION SHEET
Please complete this form and return to the Estimator assigned to your job
Customer Information
Phone No:
E-mail address:
Built Out Square Footage:
Main Floor Square Footage:
Customer’s Name:
Address:
Total Square Footage:
Upstairs Square Footage:
Desired Secondary Voltage:
1 Phase 120/240
Panel Size (in Amps):
Nearest Pole or Equipment number:
Electrical Contractor:
Request Number:
Fax No:
Unfinished Square Footage:
Basement Square Footage:
Service Description
3 Phase 120/208v
Other:
Note: Not all voltages may be available
Panel Size (in Amps):
Nearest Pole or Equipment number:
Phone No:
Load List (attach additional sheets if necessary)
Phase
Locked
Running
Load/Size
Description
(check correct one)
Rotor Amps Load Amps
(Tons*, HP, kW)
Unit
Air conditioner #1 (Largest)
Tons*
1Ø or
3Ø
Air conditioner #2
Tons*
1Ø or
3Ø
Air conditioner #3
Tons*
1Ø or
3Ø
Air conditioner #4
Tons*
1Ø or
3Ø
Air conditioner #5
Tons*
1Ø or
3Ø
Exhaust Fans
HP
1Ø or
3Ø
Forced Air Furnace
kW
1Ø or
3Ø
Electric Heat
kW
1Ø or
3Ø
Electric Water Heating
kW
1Ø or
3Ø
Electric Water Heating (on demand)
kW
1Ø or
3Ø
Boiler
kW
1Ø or
3Ø
Heat Exchanger
kW
1Ø or
3Ø
Humidifier
kW
1Ø or
3Ø
Kitchen Equipment
kW
1Ø or
3Ø
Electric Range
kW
1Ø or
3Ø
Dishwasher
kW
1Ø or
3Ø
Microwave
kW
1Ø or
3Ø
Washer/Dryer
kW
1Ø or
3Ø
Hot Tub/Spa
kW
1Ø or
3Ø
Lighting
kW
1Ø or
3Ø
Outlets
kW
1Ø or
3Ø
Computers, Magnetic Power Supplies
kW
1Ø or
3Ø
Office Equipment
kW
1Ø or
3Ø
Snow Melting
kW
1Ø or
3Ø
Swimming Pool
kW
1Ø or
3Ø
Elevator
kW
1Ø or
3Ø
Motors (include motor codes)
HP
1Ø or
3Ø
HP
Largest Motor (not included above) & code
1Ø or
3Ø
kW
Miscellaneous
1Ø or
3Ø
Future
kW
1Ø or
3Ø
kW
Totals (convert to kW as necessary)
* 12,000 BTUs per ton
It is important to provide the most accurate information available, as it is used by the Estimator to design PacifiCorp’s
facilities and determine the customer’s costs. Please sign and date this form before giving it to your estimator.
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Customer Signature
Date
You may wish to consult a trained professional (electrician, engineer, etc.) prior to providing the information to your estimator.
Install meter outdoors at a location acceptable to the Power Company. Locate the meter within 10 feet of the street side (front side) of the
residence, on the side of the residence closest to the Power Company’s source.
Motors larger than 3Ø-35hp or 1Ø-5hp will require approval by our engineering department prior to installation in order to determine the
acceptable starting current.
Revised 04Nov11