HOMEOWNER APPLICATION
Get started to upgrade to a more comfortable, healthy, efficient home! If you have any questions about this application, contact our Customer Care Team at 855-‐870-‐0049.
* Required fields
WELCOME TO ENHABIT!
To begin, please tell us how to contact you.
First Name*___________________________________________________________________________
Last Name*___________________________________________________________________________
Contact Information
This is your primary mailing address. It can be different from your home, or the building you want to have evaluated under this program.
Mailing Address (if different from residential address) *________________________________________ City* ___________________________________________State*___________ Zip Code*______________
E-‐Mail Address*________________________________________________________________________
We'll create an account so you can track your project's progress online. Please give us the email to best communicate with you.
Home Phone* (______)_________________________ Cell Phone (______)________________________
Project Location
This can be different from your mailing or primary residence addresses (if this is a second or vacation home, or you receive mail at a PO Box, for example).
Is your mailing address the same as your project address?* ___Yes
___No
Project Address* _______________________________________________________________________ City* ___________________________________________State*___________ Zip Code*______________
How did you hear about Enhabit?* ___Advertising (Radio, Newspaper etc.) ___Contractor
___Facebook
___Friend or Family Member ___Letter or Postcard in the Mail
___Link from another Website
___Local Event, Workshop or Trade Show ___News Coverage or Article
___Others
Promotional or Referral Code (Optional) __________________
You may have an Instant Rebate code if one of our partners referred you or if you are responding to an Enhabit promotional campaign.
Home Details
We need these details to determine your eligibility for the program, and to get your project started.
Do you own your own home?* (You must own your home to be eligible for our program. However, you may be eligible for other programs. Contact our Customer Care Team 855-‐870-‐0049 for additional information)
_____Yes _____ No
What type of home is this?*
(Only single family, detached homes are eligible for our program. However, you may be eligible for other programs. Contact our Customer Care Team 855-‐870-‐0049 for additional information)
_____ Single family detached _____ Condo or other multiplex
_____ Mobile home
_____ Other or I don't know Approximately what year was this home built?*____________
Utility Information
Enhabit partners with utilities in Oregon and Washington in order to assemble all available rebates into one instant savings package for your project. Help us get you the most savings, and tell us about your energy providers.
Who is your electricity provider? *
_____ Pacific Power _____ Central Electric Cooperative _____ Portland General Electric _____ Salem Electric
_____ Springfield Utility Board _____ Midstate Electric Cooperative _____ Eugene Water and Electric Board (EWEB) _____ Clark Public Utilities
_____ Ashland Municipal Electric Company _____ Douglas Electric Cooperative _____ City of Drain Light and Power _____ Consumers Power Inc. _____ McMinnville Water & Light _____ Other
Who supplies natural gas to your home?*
_____ Avista _____ Cascade Natural Gas
_____ Northwest Natural _____ My home does not have natural gas
What is the main fuel used for heating your home?* _____ Electricity _____ Natural gas _____ Oil _____ Propane _____ Wood _____ Other
What type of system heats your home? *
_____ Electric forced air furnace _____ Electric baseboard heat or wall heaters _____ Natural gas forced air furnace _____ Natural gas boiler
_____ Other
What type of system delivers your hot water? *
_____ Electric tank _____ Electric tank heat pump _____ Gas tank _____ Gas tankless/on demand
_____ Other
Free Weatherization Services
Your answers to the following two questions are used to determine whether you may qualify for free weatherization services through the Oregon Housing and Community Services. This information will not be considered in deciding whether to approve your application.
How many people live in this home?*__________
What is the approximate annual income of your household?*_____________________
For more information on whether you qualify for free weatherization services please consult the following:
• Oregon residents can turn to Appendix A or consult the following website
http://www.oregon.gov/ohcs/ Pages/sos_weatherization_oregon_income_guidelines.aspx. • Clark County, Washington residents can turn to Appendix B or consult the following website
http://www.clark.wa.gov/development/building/weatherization.html.
I have reviewed my Weatherization options* ____Yes
____No
About You
What is your age?* ____18-‐24 ____25-‐30 ____31-‐40 ____41-‐50 ____51-‐60 ____61-‐70 ____Over 70
____Prefer not to answer
What is your gender?*
____Male ____Female
____Prefer not to answer
Which of the following best describes your ethnic or racial background or heritage?* ____Caucasian
____African-‐American ____Multi-‐racial ____Asian
____Arab, Middle Eastern ____Native American ____Other
____Prefer not to answer
Do you consider yourself Hispanic or Latino?* ____Yes
____No
____Prefer not to answer
About Your Project
Help us pair you with the contractor that best meets your needs by answering the following questions.
What is the main reason you want to get started with Enhabit? * [only check one] ____Energy efficiency/weatherization (home is ineligible if built after 1993) ____Earthquake readiness (home is ineligible if built after 1970)
____Solar panels
____Radon testing & mitigation
I’m also seriously considering these additional upgrades? * [check all that apply] ____ Energy efficiency/weatherization (home is ineligible if built after 1993) ____ Earthquake readiness (home is ineligible if built after 1970)
____ Solar panels
____ Radon testing and mitigation
Terms and Conditions
I agree to the Enhabit terms and conditions (see next page) and certify that I have proper
acknowledgment and authority to submit this application on behalf of all individuals listed on the home's deed and/or heating bill.
The cost of an Enhabit home energy remodel depends on your home’s unique situation. Typical project costs for the program average between $10,000 and $15,000.
____________________________________________________________________________________ Applicant Signature Date
____________________________________________________________________________________ Co-‐Applicant Signature Date
____________________________________________________________________________________ Co-‐Applicant Signature Date
Sign and return this application to: Enhabit
1733 NE 7th Ave, Portland, OR 97212
ENHABIT APPLICATION TERMS AND CONDITIONS
PROGRAM DETAILS: Enhabit is the largest home performance provider in the Pacific Northwest. We bring together skilled contractors, lenders, home performance advisors and quality oversight into a complete total home performance solution. Details of the Enhabit product, service and rebate offers are subject to change without prior notice.
APPLICANT: The person accepting these terms and conditions is the Applicant and certifies that his/her home is eligible for Enhabit and has full authority to execute the application and accept the terms and conditions. ELIGIBILITY REQUIREMENTS FOR APPLICANT PARTICIPATING IN ENHABIT:
• Applicant owns and is the primary user of the home.
• Home is a single-‐family, site-‐built dwelling (not a mobile home, manufactured home, townhome or floating home).
• Home is located within an Enhabit Service Area, as defined on the company’s web site, http://www.Enhabit.org.
• Upon completion, home must be primarily heated with electricity or natural gas.
• Home is built before 1993 for all upgrades with the exception of radon mitigation, seismic improvements and renewables.
• Applicant agrees to allow Enhabit to bundle all available upgrade incentives, and deliver appropriate payments to contractor.
REBATE AND PROMOTIONAL OFFER ELIGIBILITY: Rebates and/or promotional offers are available on a first come, first served basis while rebates last, subject to change without prior notice, are non-‐transferable and will only be reserved for a qualified Applicant for a limited time. In no event shall Enhabit rebates and promotional offers, in total, exceed twenty-‐five percent (25%) of the total cost (before subtraction of any rebates and promotional offers) of the home performance upgrades installed. Where Enhabit has a rebate reimbursement agreement with participating utilities (or utility representative) to process their rebates, Applicant agrees that he/she forfeits applying for any rebates for installed home performance upgrades as part of an Enhabit project to participating utilities, Energy Trust, government programs and other entities participating in Enhabit and assigns those rebates to Enhabit. Rebates and promotional offers provided are estimates only and are subject to change. All home performance upgrades installed must meet Enhabit and participating utility eligibility and installation standards before rebates and promotional offers will be paid. UTILITY AND ENERGY TRUST REBATES: Applicant understands, acknowledges and accepts that any
participating local utility and Energy Trust rebates will be applied under the standards of the local utility and Energy Trust. Enhabit will process paperwork for those utilities with which Enhabit has rebate reimbursement agreements. For utilities not currently participating in Enhabit, Applicant will need to contact their utility directly for details of those rebates.
Enhabit REBATES: Applicant understands, acknowledges and accepts that any available Enhabit Rebates will be applied as a reduction in the principal amount of any loan to Applicant under the program or to reduce overall project costs if Applicant pays for projects in cash.
Enhabit PROMOTIONAL OFFERS: Applicant understands, acknowledges and accepts that any available Enhabit Promotions will be applied as a reduction in the principal amount of any loan to Applicant under the program or to reduce overall project costs if Applicant pays for projects in cash.
PARTNER PROGRAM AND COMMUNITY INITIATIVES: In the event that Enhabit partners with other programs or community initiatives, Applicant understands that the amount of funding from each source may vary based on program eligibility and Enhabit makes no guarantee of amount, which will be determined solely by the funding source or program partner requirements and may be subject to change.
PROPERTY RIGHTS: Applicant has the right and legal authority to complete and/or install the home performance upgrades in the home and that any necessary consent to carry out the upgrades has been obtained by Applicant.
ACCESS AND EVALUATION: Enhabit and/or its representatives may request access to the home and may review and evaluate the project during and after the initial assessment and completion of any home performance upgrades. Applicant agrees to provide reasonable access to the home for the purposes described herein.
VERIFICATION AND INSPECTION: An Enhabit Home Performance Advisor may verify that the installed home performance upgrades meet participating utility, utility representative, Enhabit and other participating entity requirements prior to providing authorization to disburse applicable utility rebates, Enhabit rebates and promotional offers and/or loan funds to an Applicant’s contractor. No warranty of any kind is implied by this verification process.
EMAIL COMMUNICATIONS: Applicant authorizes Enhabit and/or its representatives to send individualized and automated emails concerning the project, including scheduling updates, project status, task reminders, and future additional upgrade offers. Email addresses may be shared only with the homeowner-‐selected Enhabit contractor and/or lender. Applicants without access to email may request project updates by phone by calling Enhabit at (855) 870-‐0049.
PROJECT INFORMATION RELEASE: As used herein, “Project Information” may include personally identifiable information (“PII”) – for example, your full name, email address, mailing address, telephone number, mobile phone number or credit card number, as well as non-‐personally identifiable information (“non PII”) such as ethnicity, gender, household size, home performance upgrade installed and resulting energy-‐savings, cost of project, loan information (including name of lending institution, term, interest rate, payment schedule), FICO score, utility payment and usage data, household income, property value. Applicant agrees that Enhabit and/or its representatives may include Applicant’s Project Information, both PII and non PII, in reports or other documentation submitted to implementation partners (such as applicable contractors, lenders, and others), Enhabit’s Board of Directors, federal, state and participating local governments or government agencies, funders, Energy Trust, Oregon Public Utility Commission, Washington Utilities and Transportation Commission, and/or the Oregon or Washington Legislature. Enhabit and/or its representatives will treat PII as confidential, and the parties to whom it is disclosed (above) will treat it as confidential. Applicant
understands, acknowledges and agrees that federal, state and participating local government agencies may contact Applicant about its participation in Enhabit.
PHOTO RELEASE: Applicant authorizes Enhabit and/or its representatives to take photographs of Applicant and Applicant’s family, home and home performance upgrades and gives permission to Enhabit to use and publish the collected photographs and information concerning Applicant’s project. Applicant is willing to be contacted by members of the media about Applicant’s Enhabit project.
ENERGY INFORMATION HISTORY RELEASE: Applicant hereby authorizes Enhabit and/or Energy Trust to access utility usage data relating to the property on which energy-‐saving measures will be completed and/or
installed for a period of up to thirty-‐six months before and after completion of the work. Applicant agrees to provide other reasonable assistance to Enhabit and/or Energy Trust to obtain such information.
CREDIT AND PAYMENT HISTORY: Enhabit and /or its representatives may also request a credit check and obtain Applicant’s credit and/or FICO score in order to evaluate whether Applicant qualifies for Enhabit and loans. Applicant understands that adding additional Applicants to an application will result in a joint credit application and that Applicant has proper acknowledgment and authority to execute the application on behalf of all Applicants. Applicant understands, acknowledges and agrees that Enhabit and/or its
representatives may request access to Applicant’s utility usage payment history if needed as part of the loan approval process.
DISCLAIMER/NO LIABILITY: Applicant understands that Enhabit does not perform any upgrade work itself, but connects Applicant with a contractor that performs the work. Applicant agrees that it waives any right to seek legal recourse against Enhabit for any claims of defective work or defective performance of the home performance upgrades. Applicant agrees and acknowledges that Enhabit does not guarantee any level of energy savings results from the upgrades.
TAX LIABILITY: Enhabit and Enhabit lenders are not responsible for any tax liability which may be imposed on the Applicant as a result of participation in Enhabit or any loan or financing obtained through Enhabit. Neither Enhabit nor its lenders will provide tax advice. Any communication by Enhabit or its lenders is not intended or written to be used, and cannot be used, for the purpose of avoiding penalties under the Internal Revenue Code.
NO ENDORSEMENT: Enhabit requires contractors to use Energy Star products when available unless waived in a particular instance by Enhabit, but Enhabit does not endorse any particular manufacturer or product in promoting the program. The fact that the names of particular manufacturers, products or systems may appear on a particular program bid or other related documentation does not constitute an endorsement. Manufacturers, products, or systems not mentioned are not implied to be unsuitable or defective in any way. ALTERNATE BIDS: Enhabit provides a recommended contractor to Applicant for each Project. Any
recommended contractor meets Enhabit’s program and workforce living wage and benefit requirements and participates in Enhabit’s quality oversight program. Applicant may request an alternative contractor or request a different contractor recommendation at any time prior to contracting with a particular contractor. LOAN AMOUNT: Applicant acknowledges and accepts that the actual loan amount will not exceed the cost of performing the home performance upgrades that will be detailed in the agreed upon scope of work.
LOAN FUNDING AND CONTRACTOR PAYMENT: Where Applicant is borrowing from an Enhabit lender, when applicable, loan funds will be disbursed directly to Contractor who is installing the home performance upgrades. The exceptions to this may include Home Equity Lines of Credit, which generally disburse to the homeowner. Upon completion of the home performance upgrades and certification by Enhabit Home Performance Advisor that the installed home performance upgrades meet program requirements, All Enhabit rebates and promotional offers will be disbursed to the contractor. Applicant agrees to pay any and all cash payments pursuant to the agreed upon scope of work directly between Applicant and contractor directly to Contractor.
APPENDIX A: STATE OF OREGON WEATHERIZATION PROGRAMS
INCOME GUIDELINES
To be eligible for the weatherization assistance program, a household's income must be at or below 200% of
Federal Poverty Level (see table below). These income levels are based on household income and household size. How to Apply: OHCS uses a system of sub grantee agencies to determine applicant eligibility and delivery of
services. You apply for assistance with the community action agency nearest you.
Income Guidelines for Oregon (Federal Fiscal Year 2014)
200% of Federal Poverty Level by Household Size -‐ For use in Federal Fiscal Year 2014 Poverty Income Guidelines by Family Size -‐ Source USDOE
Household Unit Size Annual Income Monthly Income
1 $23,340 $1,950.00 2 $31,460 $2,621.67 3 $39,580 $3,298.33 4 $47,700 $3,975.00 5 $55,820 $4,651.67 6 $63,940 $5,328.33 7 $72,060 $6,005.00 8 $80,180 $6,681.67 9 $88,300 $7,358.33 10 $96,420 $8,035.00 11 $104,540 $8,711.67 12 $112,660 $9,388.33
Each additional member $8,120 $676.67
APPENDIX B: WASHINGTON STATE LOW-‐INCOME WEATHERIZATION
PROGRAM
The Federal guidance for the Washington State Low-‐Income Weatherization Program Eligibility Guidelines is 200 percent of federally established poverty guidelines. It is acceptable to consider total household income at or below 200 percent Federal poverty or 60 percent State median income, whichever is greater. However, the priority remains 125 percent of federal poverty guidelines. Columns C & D show maximum monthly and annual income for households with income that is 100 percent from wages. Further income documentation testing must be done to determine actual eligibility.
To apply, please visit http://www.clark.wa.gov/development/building/weatherization.html
2014 Income Eligibility Guidelines: Columns A and B show that maximum income allowed at 125 percent of the
poverty guidelines. Income limits are determined by multiplying the current Poverty Guidelines by 125 percent.
A. Household Size B. Average Monthly Income C. Annual Income D. Monthly Income for Wage Earners E. Annual Income for Wage Earners
1 $1,216 $14,588 $1,520 $18,235 2 $1,639 $19,663 $2,048 $24,579 3 $2,062 $24,738 $2,577 $30,923 4 $2,484 $29,813 $3,106 $37,266 5 $2,907 $34,888 $3,634 $43,610 6 $3,330 $39,963 $4,163 $49,954 7 $3,753 $45,038 $4,691 $56,298 8 $4,176 $50,113 $5,220 $62,641 9 $4,599 $55,188 $5,749 $68,985 10 $5,022 $60,263 $6,277 $75,329 11 $5,445 $65,338 $6,806 $81,673 12 $5,868 $70,413 $7,335 $88,016 13 $6,291 $75,488 $7,863 $94,360 14 $6,714 $80,563 $8,392 $100,704 15 $7,137 $85,638 $8,921 $107,048 16 $7,559 $90,713 $9,449 $113,391 17 $7,982 $95,788 $9,978 $119,735 18 $8,405 $100,863 $10,507 $126,079 19 $8,828 $105,938 $11,035 $132,423 20 $9,251 $111,013 $11,564 $138,766
