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:
Description
Air conditioner #1 (Largest)
Air conditioner #2
Air conditioner #3
Air conditioner #4
Air conditioner #5
Service Description
3 Phase 120/208v
Largest Motor (not included above) & code
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
(check correct one)
Rotor Amps Load Amps
1Ø or
3Ø
1Ø or
3Ø
1Ø or
3Ø
1Ø or
3Ø
1Ø or
3Ø
* 12,000 BTUs per ton
Exhaust Fans
Motors (include motor codes)
Request Number:
Fax No:
Unfinished Square Footage:
Basement Square Footage:
Load/Size
(Tons*, HP, kW)
Total connected Tons:
1Ø
1Ø
1Ø
or
or
or
Unit
Tons*
Tons*
Tons*
Tons*
Tons*
Tons*
HP
HP
HP
3Ø
3Ø
3Ø
Total connected HP:
HP
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
kW
Total connected kW:
kW
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.
Forced Air Furnace
Electric Heat
Electric Water Heating
Electric Water Heating (on demand)
Boiler
Heat Exchanger
Humidifier
Kitchen Equipment
Electric Range
Dishwasher
Microwave
Washer/Dryer
Hot Tub/Spa
Lighting
Outlets
Computers, Magnetic Power Supplies
Office Equipment
Snow Melting
Swimming Pool
Elevator
Miscellaneous
Future
Customer Signature



1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
1Ø
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
or
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
3Ø
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 19Nov12