Project Completion Form Checklist
HOMEOWNER INFORMATION
FULL NAME
First Name
Last Name
PHONE NUMBER
-
Area Code
Phone Number
E-MAIL
ELECTRIC PROVIDER
SCE
LADWP / OTHER CITY
SCE ACCOUNT NAME
SCE ACCOUNT #
LADWP ACCOUNT NAME
LADWP ACCOUNT #
GAS PROVIDER
SoCal Gas
LGB&O
SOCAL GAS ACCOUNT NAME
SOCAL GAS ACCOUNT #
LGB&O ACCOUNT NAME
LGB&O ACCOUNT #
BUILDING INFORMATION
ADDRESS
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
YEAR BUILT
NUMBER OF STORIES
NUMBER OF BEDROOMS
AVG CEILING HEIGHT (FT)
FT
CONDITIONED FLOOR AREA (FT²)
FT²
FOUNDATION TYPE
SLAB ON GRADE
BASEMENT FINISHED
BASEMENT UNFINISHED
CRAWL SPACE ACCESSIBLE
CRAWL SPACE INACCESSIBLE
HVAC SYSTEM
CENTRAL DUCTED HEATING AND COOLING SYSTEM
CENTRAL DUCTED HEATING SYSTEM
WALL FURNACE
IS HVAC SYSTEM A HEAT PUMP?
YES
NO
WATER HEATING FUEL TYPE
GAS
ELECTRIC
TANKLESS
PROJECT INFORMATION
TOTAL PROJECT COST
$
ESTIMATED JOB HOURS
HRS
PERMIT NUMBER
INCENTIVE RECIPIENT
CONTRACTOR
HOMEOWNER
NUMBER OF SMOKE DETECTORS INSTALLED
NUMBER OF CARBON MONOXIDE DETECTORS INSTALLED
SELECT MEASURES
DUCT SEALING
≤ 10% = $250
≤ 6% = $650
DUCT INSULATION
≥ R - 8 = $550
CENTRAL AIR CONDITIONER
≥ 15 SEER = $750
CENTRAL FURNACE
≥ 92% = $600
≥ 95% = $700
WALL FURNACE
≥ 70% = $400
ATTIC INSULATION
≥ R - 38 = $550
≥ R- 44 = $650
GAS STORAGE & WATER HEATER
EF ≥ 0.67 = $350
EF ≥ 0.70 = $450
GAS TANKLESS WATER HEATER
EF ≥ 0.82 = $900
ELECTRIC WATER HEATER
EF ≥ 2.00 = $400
DOCUMENTATION
INCENTIVE APPLICATION
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INVOICE
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SIGNED CONTRACT
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ABATEMENT CERTIFICATE
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NOTES
SUBMIT FORM
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