King County: Healthy Buildings Program Application

The Healthy Buildings program provides no-cost building air-quality improvements in single-family homes and single-family rentals in King County.

To be eligible for this program:

• The home must be located in within a 10 mile boundary of SeaTac International Airport. 
• The combined household income must be less than 80% of Area Median Income.

King County will cover 100% of installation costs of air quality improvement measures, such as insulation, air sealing, weatherization, ventilation, heat pump installation or home appliances.

Please submit your application using the form below. If you have any questions or would like to submit a paper version of this application, please contact energize@kingcounty.gov. 

Definitions

Adult: any person 18 years or older.

Household: all persons in your household, living at the same address. A household may be a family, two or more families living together, or any other group of related or unrelated persons sharing living arrangements.

Income: the total annual income before taxes of all family and non-family members 18+ living within the household. It includes all gross wages, tips, rental income, public assistance, social security or pensions, income from self-employment, alimony, interest, unemployment benefits, public assistance or any other sources of income defined by the IRS income tax return for the previous tax year.

Determining My Household’s Annual Income

A good way to determine your household’s annual income is by looking at last year’s tax returns.

• If the only adults in your household are you and your partner or spouse, a jointly filed tax return for the previous year would provide your household income.
• If you filed separate tax returns than your partner or spouse, or you have multiple adults in your household that filed separately, you would combine the incomes of each separate tax return.

If your household income changes prior to installation, such that your household no longer qualifies for the installation, it is expected you will notify your Healthy Buildings Program case manager.

Please review the following Annual Income Limit Chart:

Household Size	Income Limit
1	$77,700
2	$88,800
3	$99,900
4	$110,950
5	$119,850
6	$128,750
7	$137,600
8	$146,500

Income Information

For applicants whose household income is below the limit listed in the Income Limit Chart, King County will cover 100% of installation costs.

Please note that King County may require documentation of your household's annual income in order to qualify for Healthy Buildings. One of the following documents can be used to qualify for Healthy Buildings. You have the opportunity to upload a digital copy of one the following below. 

• IRS 1040 for most recent tax year
• Past three months' of paystubs
• Seattle City Light Utility Discount Program - Utility bill stating enrollment
• Medical (Apple Health-Medicaid) - ProviderOne Number with Health Care Authority or DSHS
• Basic Food (also known as SNAP) - ACES ID number
• Cash Assistance (DSHS) - ACES ID number
• ORCA Lift - ORCA Lift ID number on the back of your card
• Social Security Benefits - Copy of your award letter
• Veterans - Since it’s a federal program, we’d need a copy of your award letter
• ABD (Aged Blind Disabled) - ProviderOne Number with DSHS
• SSI (Supplemental Security Income) - ProviderOne Number with Health Care Authority

HEPA Filter Information: BlueAir 211i Max HEPA air filter

 Property Address: {address}

If you are eligible to receive King County home improvement services, the work will be performed by a qualified approved licensed contractor. The contractor will obtain all necessary permits required by the local permitting authority, and the installation will be inspected by the state or local permitting agency once complete.

Owner and/or Resident Acknowledgement

Indemnification: I hereby release and pledge to hold harmless, indemnify and defend King County, it’s agents, elected and appointed officials, servants and employees (collectively, “Indemnified Parties”), harmless from and against any liability and all claims for injuries, sickness or damage to persons or property of whatsoever kind or character in connection with the work, or any act or eventuality arising from this work, performed by any of the Indemnified Parties and any business contracted by any of the Indemnified Parties to perform work in the home located at the address listed above.

Attest by signing below, I agree to provide access to my home (address listed above) by the King County Healthy Buildings program contractors and their crew members for purposes of site evaluation, testing, installing a heating system, improvements listed on work orders, and follow-up inspection(s). I hereby release and hold harmless King County, and it’s employees, from any liability in connection with the work.

Public Records Disclaimer

I acknowledge that this application, and all information contained herein, is a public record and may be subject to disclosure.

Interpretation Service Disclaimer

Interpretation service provided in support of the King County Healthy Buildings Program is intended as a supporting service. Interpreters will attempt to provide accurate interpretation. Interpretation services do not, and are not intended to, constitute legal advice. King County, its officers, employees, and/or agents shall not be liable for damages or losses of any kind arising out of, or in connection with, the use of interpretation services.