Asterisks (*) indicate required fields.
CUSTOMER INFORMATION
Account Number
*
Are you the account holder?
*
Yes
No
Relationship to Customer (if not account holder)
*
Family Member
Landlord
Tenant
Name
*
First
Last
Phone
*
Email
*
Installation Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Do you have a different mailing address?
*
My mailing address is the same as above
I have a different mailing address
Mailing Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
HOME INFORMATION
Residence Type:
*
Site Built Home (Four-plex or less)
Multi-Family Home (Five-plex or more)
Manufactured Home
Multi-Family Type:
*
Low Rise (5 or more units, 3 stories or less)
Mid/High Rise (6 or more units, 4 stories or higher)
Electric Heat Source:
*
Residence must have permanently installed electric heat system capable of heating entire dwelling to qualify.
Baseboard
Ceiling Cable
Wall/Cadet
Heat Pump
Electric Forced Air
Other
Other Heat Source:
*
ENERGY EFFICIENT UPGRADES
I plan to install:
*
(Check all that apply)
Attic Insulation
Floor Insulation
Wall Insulation
I plan to install:
*
(Check all that apply)
Attic Insulation
Floor Insulation
I plan to install:
*
(Check all that apply)
Attic Insulation
Wall Insulation
Installation Method
*
Contractor Installed
Self Installed
Attic Insulation
Please input any additional R-values into the Notes section at the bottom of this form.
Existing R-Value
*
Final R-Value (proposed)
*
Area (sq ft)
*
Floor Insulation
Please input any additional R-values into the Notes section at the bottom of this form.
Existing R-Value
*
Final R-Value (proposed)
*
Area (sq ft)
*
Wall Insulation
Please input any additional R-values into the Notes section at the bottom of this form.
Existing R-Value
*
Final R-Value
*
Area (sq ft)
*
REBATE PROGRAM GUIDELINES
Please click the button below to find current rebate amounts. This will open a new tab.
Rebate Amounts
All requests for rebate funds must be pre-approved. If the work is not completed within six months of approval, customer must reapply for rebate(s). There is no guarantee that funds will be available after the six-month approval or that the incentive amount will remain the same. Rebate(s) are available on a first come, first served basis and are subject to availability of funds.
Before Installation
: An audit and prior approval are required. Call 503-266-1156 to schedule.
All energy efficient upgrades must be installed according to Canby Utility specifications.
Wall insulation
: In-progress photographs required before, during & after insulation installation. The pictures must be included with the final paperwork submission.
After Installation
: A final inspection is required before the rebate can be processed. Please call 503-266-1156 to schedule after the work has been completed and all required documents have been submitted.
Rebate(s) will not exceed 70% of the installed job cost. Rebate(s) for self-installed energy efficient upgrades will not exceed 70% of the cost of materials.
All requests for rebate funds must be pre-approved. If the work is not completed within six months of approval, customer must reapply for rebate(s). There is no guarantee that funds will be available after the six-month approval or that the incentive amount will remain the same. Rebate(s) are available on a first come, first served basis and are subject to availability of funds.
Before Installation
: An audit and pre-approval are required. Call 503-266-1156 to schedule.
All energy efficient upgrades must be installed according to Canby Utility specifications.
After Installation
: A final inspection is required before the rebate can be processed. Please call 503-266-1156 to schedule after the work has been completed and all required documents have been submitted.
Rebate(s) will not exceed 70% of the installed job cost. Rebate(s) for self-installed energy efficient upgrades will not exceed 70% of the cost of materials.
UPLOAD YOUR FINAL DOCUMENTS
The following documents are required before final inspection of the new insulation:
Contractor installed: copies of
contractor final invoice(s)
noting R-value of existing insulation, R-value of final insulation and square footage of added insulation. The date of the installation and invoice date must be on or after October 1, 2019. Include in-progress wall photos, if applicable.
Self-installed: copies of
purchase receipt(s)
noting R-value of existing insulation, R-value of final insulation and square footage of added insulation. The date of the installation and invoice date must be on or after October 1, 2019. Include wall photos, if applicable.
The following documents are required before final inspection of the new insulation:
Contractor installed: copies of
contractor final invoice(s)
noting R-value of existing insulation, R-value of final insulation and square footage of added insulation. The date of the installation and invoice date must be on or after October 1, 2019.
Self-installed: copies of
purchase receipt(s)
noting R-value of existing insulation, R-value of final insulation and square footage of added insulation. The date of the installation and invoice date must be on or after October 1, 2019.
*
Drop files here or
Select files
Max. file size: 20 MB.
Application Notes
Please insert any notes that you would like us to review with your application.
SUBMIT YOUR APPLICATION
Terms and Conditions
*
By clicking "submit," the applicant acknowledges the following:
Rebate offer(s) may be changed or discontinued at any time by Canby Utility (CU). CU rebate(s) will be processed at the current rebate level. CU disclaims any warranty, whether expressed or implied, regarding the energy efficient upgrade(s) listed on this application for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use.
I understand that the energy efficient upgrade(s) must be installed to CU specifications, and certify that I, or my contractor, have reviewed the specifications prior to beginning work. When selecting a contractor, I understand that it is the homeowner’s responsibility to request proof of insurance and licensing that meets the statutes and rules of the Oregon Construction Contractors Board. CU strongly recommends validating qualifications before work begins.
I understand the above and certify that I am a customer of CU, that the energy efficient upgrade(s) are installed at the address indicated and that this address is within CU service territory.
I agree
Allow 8 to 10 weeks after final inspection and receipt of all required documentation for rebate processing.
Call 503-266-1156 to learn about additional energy efficiency programs.