Energize AFH 2026 Application

Energize 2026: Adult Family Homes
Instructions and Notes

Thank you for your interest in the Energize – Adult Family Homes program. This program provides program participants with a combination of the following items, depending on the building needs:
- Heat pump installation to provide high efficiency heating and cooling
- Insulation, air sealing, and ventilation (also known as weatherization) to improve energy efficiency, health, and comfort
- Heat pump water heaters for low-cost water heating
- Induction cookstoves
If approved for the program, King County will pay for all costs associated with the installation of equipment, and related labor and materials. King County will manage all installations, including hiring and paying contractors. This is not a grant program.

To apply for this program, you must operate an Adult Family Home, as defined in RCW 70.128.010 (1), licensed by Washington State Department of Social and Health Services (DSHS), and located in King, Kitsap, Pierce, or Snohomish County of Washington State.

While not an eligibility requirement, this program prioritizes Adult Family Homes located in frontline communities, defined as those located in any of the following geographies:
- Puget Sound Clean Air Agency overburdened communities
- WA Environmental Health Disparities Map score of 9 or more
- 2024 U.S. EPA defined low-income and disadvantaged communities
Generally, these geographies share poorer air and soil quality, higher noise pollution, closer proximity to hazardous waste treatment and storage facilities, and greater risk of related negative health outcomes. Additionally, they experience reduced resiliency to climate change.

Search your address on the map to see if your property is located in a frontline community geography.

Applications will also be scored and prioritized based on the following:
- Use of fossil fuels in building systems and appliances
- Building characteristics
- Priority geographies
- Climate preparedness potential
King County reserves the right to decide which participants to move forward with based on alignment with County and grant funding goals.

If you have any questions, please email energize@KingCounty.gov.

* Indicates required question.

Applicant Questions
Who is the primary point of contact for this application?
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Relationship to the building*
e.g. Homeowner, Renter, Property Manager, Building Operator, Building Owner
Preferred Language*
By applying for this program, you understand that you may not automatically receive program services. This is a competitive application process, and only those accepted into the program receive program services.

What is the applicant's relationship to the building?

Participating in this type of program requires approval from the building/homeowner and any other key decision-makers for the building/home. I understand that if selected into the program, the building owner and any other key decision-makers will have to approve participation.

If the building is rented, ONLY the renter is eligible to apply for the program. The homeowner is not eligible to apply, although they have to approve the program participation.
I am:*

The homeowner (and the occupant)The renterOther (please describe)
In what year did you become the owner of the building? If an exact year is not known, please provide an estimate.*
Landlord Contact Information
Landlord Name*

First NameLast Name
Landlord Email*
example@example.com
Landlord Phone Number*
Please enter a valid phone number.

Adult Family Home Questions
Name of Adult Family Home (AFH)*
Washington State Adult Family Home License Number*
Do you co-own the AFH with another person?*

YesNo
Co-owner Contact Information
Co-owner Name*

First NameLast Name
Co-owner Email*
example@example.com
Co-owner Phone Number*
Please enter a valid phone number.
Do you operate any other Adult Family Homes?*

YesNo
How many Adult Family Homes do you operate?*
If you own/operate more than one adult family home, you must submit an application for each adult family home separately.
Does your Adult Family Home serve a population that primarily speaks a language other than English?*

YesNoI don't know
How many residents does this Adult Family Home serve?*
How many residents in this Adult Family Home are funded by Medicaid?*

Client Release Form
If you are eligible and selected to receive King County Energize – Adult Family Homes Program 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, its agents, elected and appointed officials, servants and employees, in addition to Energize Program funders including Puget Sound Energy, and other current or future funders, and their agents, officials, 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 Energize 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 its employees, from any liability in connection with the work.
Applicant Signature

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Date Signed

MonthDayYear
Date

Disclaimer
Public Records Disclaimer

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

Data Access & Sharing Disclaimer

I acknowledge that if approved for installations, I will be required to provide King County and PSE, upon request, access, inspection, and account/consumption data for evaluation and quality assurance purposes. I will also authorize King County to share utility data with program contractors and consultants for installation, energy efficiency verification, and greenhouse gas reporting.

Interpretation Service Disclaimer

Interpretation service provided in support of the King County Energize 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.

Signature (Must be the home occupant or an authorized representative of the home occupant) I understand the Public Record and Interpretation Services Disclaimers stated above.
Applicant Signature

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Date

Application Attestation
Attestation

I attest that the answers provided in this application are true and accurate to the best of my knowledge.
Applicant Signature

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MonthDayYear
Date
Should be Empty:

Energize 2026: Adult Family Homes

Applicant Questions

Landlord Contact Information

Adult Family Home Questions

Co-owner Contact Information

Building Characteristics

Building Systems

Demographics

Client Release Form

Disclaimer

Application Attestation