Air Source Heat Pump Upgrade Form

For Upgrading Existing Electric Heat Pumps or Non-Electric Heating Systems to Heat Pumps

All sections must be completed by the installer at the time of installation.
Eligibility

Household Information

Jefferson County PUD Customer Name(Required)
Available on PUD bill or in Smart Hub App
Mobile or home phone
Installation Address(Required)
Needs to be the same as PUD customer's service address.
MM slash DD slash YYYY

Home Type

Existing Site-Built
Existing Manufactured (Number of Sections)
Existing Heating System Being Replaced(Required)
*This measure doesn't apply if the existing heating system is a ductless heat pump.

Please note: Heat pump outdoor compressor type must be variable-speed.

Documentation to submit with this form:

Must include heat pump make and model number.
Drop files here or
Accepted file types: jpg, jpeg, gif, png, pdf, heic, doc, docx, Max. file size: 128 MB.
    Please attach.
    Drop files here or
    Accepted file types: jpg, jpeg, gif, png, pdf, heic, doc, docx, Max. file size: 128 MB.
      The certification from the Air Conditioning, Heating, & Refrigeration Institute (AHRI) that verifies the performance of the equipment.
      Drop files here or
      Accepted file types: jpg, jpeg, gif, png, pdf, heic, doc, docx, Max. file size: 128 MB.
        If a variable-speed compressor, including manufacturer documentation that the outdoor compressor includes variable-speed or inverter-driven technology (e.g. specification sheet, brochure, or screenshot). Note: Including the test "variable speed" on the invoice will not satisfy this requirement. Additional documentation is required.
        Drop files here or
        Accepted file types: jpg, jpeg, gif, png, pdf, heic, doc, docx, Max. file size: 128 MB.

          PRIVACY ACT STATEMENT Basic authority for collecting this information is authorized by 16 U.S.C. §§ 832 et. seq., and 838 et. seq., pursuant to Bonneville Power Administration’s Conservation Program system of records established in 46 FR 31700. This information is primarily intended to further, but is incidental to the performance of, BPA’s overall Energy Efficiency Program, the objective of which is to acquire energy resources through energy efficiency, to determine what cost-effective conservation and direct application renewable resources measures should be installed or adopted under different circumstances, and to provide incentives for the installation of such measures. Other routine issues of this information include: aggregation into a public database on energy efficiency; furnished to authorized personnel for installation/repair of equipment; aggregated into a database for program publicity; and in some instances information regarding buildings will be made available to subsequent purchasers of the buildings. Your disclosure of the requested information is voluntary; however failure to provide requested information means that it will not be possible for you to participate in this BPA Energy Efficiency program.

          Direct Mail

          Jefferson County PUD, 310 Four Corners Road Port Townsend, WA 98368
          This field is for validation purposes and should be left unchanged.