Residential Heat Pump Pre-Authorization Request Form

Residential Heat Pump Pre-Authorization Request Form
⚠ This form is for HVAC contractors. The Heat Pump Pre-Authorization request must be submitted by the HVAC contractor. Please contact Customer Energy Solutions at (509) 661-8008 if you have questions.
What type of new system are you planning to install? (Select all that apply.)
Let's make sure you have the right information handy.
Customer Information
- Chelan PUD customer name, email, and phone number
- Installation address
- Meter number
Existing System Photos

Unless this is new construction, please provide photos for all existing systems, including the existing outdoor and indoor unit(s). For each system, please include a:
- Wide shot: Showing the equipment and its surrounding area, and a
- Nameplate: Close up showing the equipment nameplate.

Contractor Information

Tell us a little bit about you!
Contractor Company Name
Your Name

First NameLast Name
Your Email
example@example.com
Your Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Additional Contractor Email (Optional)
Is there anyone else in your office that you'd like to receive a copy of this submission? Please enter their email address.

Customer Information

Tell us a little bit about your customer.
Customer Name

First NameLast Name
Customer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Customer Email
example@example.com
Installation Address

Street Address

City

Zip Code
Chelan PUD Meter Number
This helps us make sure we're looking at the right meter for this customer's energy usage data.
Square Footage of Home

Ductless Heat Pump Project Information
What type of home is this?
What type of existing heating system do they have?
Upload Existing System Photos

Please include at least two photos of the existing heating system including: 1) A wide shot showing the equipment and its surroundings, and 2) A close up of the equipment nameplate.
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DHP Project Type

Initial Rebate Estimate
⚠ Initial estimates are subject to change. Project eligibility will be reviewed by Chelan PUD as part of the Heat Pump Pre-Authorization process. Initial incentive estimates are not a guarantee.
- Heat Pump System 1 Initial Estimate*
- Measure Type
- Heat Pump System 2 Initial Estimate*
- Measure Type
- Ductless Heat Pump Initial Estimate*
- Measure Type

Ready to Submit this Request?
Great! Once you hit "Submit" you'll receive an email for your records and we'll review your information and reach out if we need any additional information. If you have any additional comments, please leave them in the field below.
Any additional comments?
Should be Empty:

Let's make sure you have the right information handy.