Energy-efficient water heating equipment

rebate application
Puget Sound Energy offers a variety of rebates for high-efficiency Which rebate are you applying for?
water heating systems for our natural gas and electricity Electric water heating systems
customers to help them save money and the environment. Heat pump water heater
Available rebates and qualifications are listed on the Where was it installed: Garage Attic Crawl space
back of this form Other:________________________
Electric storage water heater
For more information, contractor referrals or for help Waste-water heat recovery system
completing this form, call a PSE Energy Advisor at Natural gas water heating systems
1-800-562-1482, Monday through Friday, 8 a.m. to 5 p.m.
Tankless water heater
Directions: Natural gas storage water heater
Carefully fill out this application and submit to PSE securely
attaching legible copies of receipts or invoices that clearly
Equipment manufacturer Model number
show the equipment brand name and full model number.
Please keep copies for your records.
Date installed Purchase/Installation cost
Mail to: Puget Sound Energy, Energy Efficiency Rebate
Program, P.O. Box 97034, EST-10W, Bellevue, WA 98009-9734
Installing Contractor

PSE ACCOUNT NUMBER (10 DIGITS) PSE will review your rebate application and determine if your new equipment
qualifies for a rebate. Applications with missing or incomplete information will not
be processed. Please allow six to eight weeks for processing.
REFERRAL NUMBER (OPTIONAL)
By signing below you acknowledge that: your qualifying natural gas equipment
is installed at a residence in PSE’s natural gas service area and/or your qualifying
electric equipment is installed at a residence in PSE’s electric service area;
NAME OF PERSON REBATE CHECK SHOULD BE MADE PAYABLE TO PSE may inspect these products upon request; PSE has made no implied or
express warranties or representations with regard to these products or energy
savings from their installation; this is a tariffed service and is subject to change or
DAYTIME PHONE termination without prior notice.
I have read, understood and agreed to the terms and conditions of this service
and certify that the equipment described above has been purchased and
FULL INSTALLATION ADDRESS
installed at the location indicated.

SIGNATURE _______________________________________________
CITY STATE ZIP
DATE _______/_______/_______
MAILING ADDRESS (IF DIFFERENT)

CITY STATE ZIP

E-MAIL ADDRESS Yes, sign me up for PSE’s free Energy at Home e-newsletter.

About your home:

For Puget Sound Energy use only

Sq. footage of home Number of Occupants Year built
COMMENTS
Your home is: Owner occupied Rental home ____________________________________________________
Home has a natural gas meter (even if only used for cooking): ____________________________________________________
Yes No ____________________________________________________
Type of home: Site-built Manufactured
____________________________________________________
Foundation type: Basement Crawl space DATE: ______/______/______
Slab-on-grade Other APPROVED Yes No
TOTAL AMOUNT REBATED: $________________________________
Electric water heating systems
Heat pump water heater
• $250 rebate
• Must install ENERGY STAR® qualified equipment
• Must be installed outside living space such as a garage,
attic or crawl space
Electric storage water heater
• $50 rebate
• Must install equipment with an Energy Factor (EF) of .94
or higher
• Must be a minimum of 50-gallon rated capacity
• Indirect water heaters do not qualify
Waste-water heat recovery system
• $250 rebate
• Equipment must have an efficiency of 42 percent or
greater. Visit PSE.com for a list of qualifying models
• Equipment must be installed vertically. Horizontal
application is not eligible
• Must currently heat water with an electric water heater.
Electric tankless water heaters are not eligible
• Homemade systems are not eligible
Converting to natural gas
When available, PSE recommends using natural gas
directly for space and water heating. You may be
eligible for conversion rebates. Visit PSE.com/Rebates
for more information.
Natural gas heating systems
Tankless water heater
• Tier 1 - $150 rebate
-- .82 EF or higher
• Tier 2 - $200 rebate
-- .90 EF or higher
• Must install ENERGY STAR qualified equipment
• Natural gas hybrid water heaters, indirect water heaters
and storage condensing water heaters do not qualify
Natural gas storage water heater
• $50 rebate
• Must install ENERGY STAR qualified equipment
• Natural gas hybrid water heaters, indirect water heaters
and storage condensing water heaters do not qualify
1620 12/09
General qualifications
• Rebate application must be submitted within 90 days of
equipment installation
• Qualifying natural gas equipment must be installed in
PSE’s natural gas service area and qualifying electric
equipment must be installed in PSE’s electric service area
• Applies to existing single-family properties (including
manufactured) or individually-metered attached housing
with four units or less
• One rebate per qualifying piece of equipment. For heat
pump water heater and waste-water heat recovery
system rebates, one rebate per qualifying metered,
residential customer
• Equipment that is replaced under warranty will not be
eligible for second rebate
• Must install to comply with all federal, state and local
code requirements
• PSE may inspect installation for compliance
with qualifications
Keep saving:
Save even more energy with these PSE energy-efficiency
incentive programs and services
• HomePrint™ home performance evaluation
• High-efficiency heating equipment rebates
• Insulation and window upgrade rebates
• High-efficiency natural gas fireplace rebate
• Compact fluorescent lighting instant rebates
• Contractor referrals: PSE’s Contractor Referral Service
makes it easy to find a pre-screened, independent
contractor for nearly any product replacement or home-
improvement project
For a free, no-obligation referral to a contractor in your area or
for more information about PSE energy-efficiency programs,
visit PSE.com/ForYourHome or call a PSE Energy Advisor at
1-800-562-1482, Monday through Friday, 8 a.m. to 5 p.m.