Residential Structures: Mechanical Design and Energy Analysis Report Submit this form to secure engineering analysis reports and mechanical layouts. Sales Representative First Last Date Submitted* MM slash DD slash YYYY Contact Name* First Last Contact PhoneContact Email* Project Name Project Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Name / Address to Return Information:Technical InformationPlease fill out as much of this information as possible to ensure accurate engineering.Total Heated & Cooled Living Square Footage:Direction Front Door Faces: HVAC Brand: A/C-SEER/EER Rating: Heat Pump or Gas Heat:Geothermal Heat PumpElectric Heat PumpGas HeatAFUE Rating: Where Will the Ductwork be Located?AtticCrawlspaceBasementDuct R-Value: Specific Zoning Requests:If your customer has specific zoning requests, please enter the details here.Special load requirements:Are there any rooms with exceptional loads that we should be aware of? For example, does this homeowner have many parties, media room, game room, indoor spa, etc…Wall Construction:2 x 42 x 62 x 4 Staggered Stud2 x 6 Staggered StudCeiling Type:Flat CeilingRoof DeckVaulted CeilingCeiling Insulation Preference:6" of OC - SPF3" of CC - SPFOtherIf "other" was selected for ceiling insulation preference, please describe: Floor TypeSlabCrawl SpaceBasementFloor Type R-Value: Window Frame Type:VinylCellularFiberglassWood/CladOtherIf "other" was selected for window type, please describe: Window Panes:DoubleTripleArgon Gas FilledOtherIf "other" was selected for window panes, please describe: Window Glazing:ClearTintedLow-EOtherIf "other" was selected for window glazing, please describe: Ceiling Heights, Fireplaces, Skylights and Recessed Lighting:Please provide a detailed description of ceiling heights and whether there are fireplaces, skylights and recessed lighting and where they are located.Section 1: Standard Pricing OptionEnergyWise Master Class Dealer Residential Energy Analysis Fees:I am choosing pricing under Section 2.1 to 3,000 sq ft: $3003,001 to 5,000 sq ft: $4005,001 to 7,000 sq ft: $500For every additional 2,000 square feet add $100.00 Section 2: Smaller Home Special Pricing OptionIn order to better serve smaller homes, this package includes an EnergyWise Energy Analysis, Consulting (if necessary), Stamped Mechanical Layout and Energy Usage Guarantee for a total of $0.30 per square foot for homes ranging from 0 to 2,500 square foot (heated and cooled space). If you've chosen this pricing option, please calculate your price at $0.30 per square foot and add it below: Price includes both the EnergyWise energy analysis report and mechanical layout.Section 3: Optional Mechanical Drawings with Duct LayoutAll residential mechanical drawings are engineered and overseen by Michael R. Busby, PhD, PE, priced at $ 0.15 per square foot of heated and cooled area. Residential plans are not normally stamped* and are drawn by hand. If you would like to have them drawn in Auto-CAD and stamped, we can do that for an additional fee. NOTE: *We are not registered in all 50 states, and we can only stamp plans in states in which we are registered. If an EnergyWise dealer generates enough business in a state where we are not yet registered, EnergyWise will, at our expense, go through reciprocity to obtain registration in that state. Mechanical Drawing: ($0.15 per square foot) Note: The optional fee for mechanical drawings applies to Section 1 applicants only. The fee for mechanical drawings is automatically included for those selecting Section 2 pricing.Additional Fees (if applicable):If applicable, please make the appropriate selections below if the home has three or more levels, you desire 3 business day rush service or if you've emailed your plans to us.Three or more level surcharge (due to engineering complexity):Not three levels.Three or more levels: $100Rush Service: 3-Business Day Turnaround:Not applicable.Rush charge: $35Emailed Plans Printing Fee:Not applicable.Printing fee: $20If you've emailed your plans to us, a $20 in-house printing fee is required. Email: analysis@energywisestructures.comTotal $0.00 The total fee calculation is your your convenience. Please write a check to that amount and submit to the address below or call us with your credit card information. Also, remember to click the "Submit" button below to send the application. Thank you!Final Check List1. Set of Floor Plans, Elevations and Electrical (including door and window sizes). 2. Residential Application Filled Out and click "Submit" button. 3. Payment Arrangements (check or phone-in credit card). If paying by check, please mail to: EnergyWise 1216 North Central Expressway, Suite 208 McKinney, Texas 75070 Email: analysis@energywisestructures.com You may also call us and provide your credit card information. CAPTCHA
