Residential Solar Water Space Heating Application

8/9/2019 Residential Solar Water Space Heating Application

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ACC APPROVED 4/10/08

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TUCSON ELECTRIC POWER COMPANYRESIDENTIAL SOLAR WATER SPACE HEATING APPLICATION

Customer Information

Name (As it appears on utility bill) _____________________________________________________________Mailing Address __________________________________________________________________________

City ________________________ , AZ Zip Code ____________________________________________

Street Address (If different from above) ________________________________________________________

Daytime Phone Number ____________________________________________________________________

E-mail Address: ____________________________________ Account _______________________________

Operating Agent (If different from Customer)_____________________________________________________

Domestic Solar Water Heating systems will be rated by the SRCC and meet the OG-300 system standard.Systems that include OG-100 collectors, but are not certified under OG-300, will need to be verified by

submitting a testing certification for a substantially similar system prepared by a publicly fundedlaboratory. Solar Space Heating systems will utilize OG-100 collectors.

Active, open-loop systems are not eligible for incentives except for active, open-loop systems that have aproven technology or design that include appropriate automatic methods for freeze protection.

System Information

OG 300 Certification Number_____ ______

Estimated annual kWh savings based on OG300/SRCC Rating __________ (for Gas: kWh = therms x 29.3)

Active Passive Open Loop Closed Loop Thermosiphon

Horizontal Tilt Angle __________ (20 and 60 Degrees or 30 and 60 degrees forspace heating applications)

Azimuth Angle __________ (+/- 60 degrees of due south)

Type of Mount: Roof Ground

Shading: None Other: ____________________________________________________________

Type of corrosion protection: Anodic Cathodic

Collector Manufacturer____________________ Model _________________ Quantity_________________

Total Collector Area _____________________ Collector Material ________________________________

Minimum collector wall thickness (for ICS is .058 inches or greater) __________________________________Solar Storage Volume __________________________

Heat Exchanger: Internal (Immersion) Wrap around the tank External None

Drainback Tank Model # _________________________ Manufacturer ______________________________

Draindown Tank Model # ________________________ Manufacturer ______________________________

Type of Antifreeze ________________Concentration ______________ Manufacturer ________________

Controller Model # _____________________________ Manufacturer ______________________________

Pump Model # ________________________________ Manufacturer ______________________________


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System Information (continued)

Freeze Protection: Manual Automatic Antifreeze Other:

Backup Heat: Electric Gas Instantaneous Standard Tank

Total Cost ______________ System Cost ____________________ Labor Cost ______________________

Estimated Installation Date __________________________________________________________________

Warranty Information

Contractors must provide a minimum warranty period of five years for labor and repair/replacementservice to the customer for warranted items. For out of warranty items prior to year five, customers willnot be charged for labor.

Collector, heat exchanger and storage units need a factory warranty of ten years for UFI and five yearsfor a PBI.

Collector ____ yrs Storage _____ yrs Pump _____ yrs Controller _____ yrs

Installation/Workmanship Warranty _____ years

Copy of equipment specifications must be attached to application.

Rebate Calculation Up Front Incentive (UFI)

OG300 rating in annual kWh savings (for gas, kWh = therms x 29.3) x $0.25* + $750 up to amaximum of $1,750

OR

TEP Payback = Total cost 15% (Customers Portion) $2,000 (Max Federal Tax Credit) $1,000 (Max State Tax Credit)

Actual payment made to customer will be the lesser of the two parameters up to the maximum of $1,750.

Total TEP payback cannot be more than 60% of total system cost.Customer must pay at least 15% of the total system cost.

Rebate Calculation Performance Based Incentive (PBI)

OG 300 rating in annual kWh savings _____ kWh x PBI $_____ x _____years term = Total Rebate ___________

PBI Rebate: $0.057/kWh for 10 years, $0.052 kWh for 15 years, $0.051/kWh for 20 years

Total TEP payback cannot be more than 60% of total system cost.Customer must pay at least 15% of the total system cost.

Optional Customer Reservation Bid

*Customer may elect to receive less than $0.025 kWh to improve ranking on reservation list.

Project InformationHas a City/County Permit been secured? Yes No

Does this installation meet all ACC Interconnection/REST requirements? Yes No


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System Qualifications

The system must meet the requirements outlined in Attachment A of theResidential Solar Water Space Heating Agreement.

Stagnation temperatures do not pose a problem with this system.

______________________________________ Installer Signature

System is properly sized according to the geographic location and hot water needs of the specific application.

______________________________________ Installer Signature

Installer Information

Installer/Dealer Name ______________________________________________________________________

Business Address _________________________________________________________________________

Arizona Registrar of Contractors (AZROC) License Information

AZROC License Number ________________________Class _______ Expiration Date________________

Assignment of Payment

I authorize Tucson Electric Power (TEP) to issue, on my behalf, my full rebate to the following installer/dealer aspayment toward the cost and/or installation of my PV system. I acknowledge that the payment made to the belownamed installer satisfies the financial obligation to me in connection with the Agreement signed by myself andTEP.

Company Name____________________________________________________________________________

Contact Person ____________________________________________________________________________

Business Address __________________________________________________________________________

Customer Signature__________________________________________ Date _________________________

Solar Water System Inspection Authorization

TEP, at its option, may perform periodic inspections of the system to ensure it is operating efficiently and safely.Presently TEP out sources all inspection services to a qualified third-party contractor. Do you authorize TEP touse a qualified third party contractor for your annual inspection?

Authorization Agreed Authorization Denied

There are animals in the yard that the Program Inspector needs to be aware of: Yes No

WHEN COMPLETE PLEASE MAIL TO: Renewables, PO Box 711, Mail Stop DS501, Tucson, AZ 85702

Documents

Residential Solar Water Space Heating Application