Load Data Sheet

All information MUST BE provided.

"*" indicates required fields

Company

This field is for validation purposes and should be left unchanged.

Project Information

Customer's Name

First Last

Nature of Business*

Email*

Location

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Voltage Requested:

Date Temp Service Needed:

Date Perm Service Needed:

Square Footage Conditioned:

Total Square Footage:

Owner's Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Phone:

Work Phone:

Mobile Phone:

Fax:

Service Entrance Information

Service Type (Phases):

Phase Conductor Size:

Numbers of Conductors per Phase:

Neural Conductor Size:

Information Provided By:

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Project Contact:

Telephone Number:

Load Estimates

Check One:

New Construction

Renovation

Existing Load (kW) if Renovation - Single Phase:

Existing Load (kW) if Renovation - Three Phase:

Connected/Added (kW)

Lighting - Single Phase:

Lighting - Three Phase:

Air Conditioning - Single Phase:

Air Conditioning - Three Phase:

Heating - Single Phase:

Heating - Three Phase:

Water Heating - Single Phase:

Water Heating - Three Phase:

Cooking - Single Phase:

Cooking - Three Phase:

Refrigeration - Single Phase:

Refrigeration - Three Phase:

Receptacles - Single Phase:

Receptacles - Three Phase:

Miscellaneous - Single Phase:

Miscellaneous - Three Phase:

Motor Load - Single Phase:

Motor Load - Triple Phase:

Largest Single Motor (hp):

Any Additional Information:

This is NOT a request for service.