Residential Energy Analysis Order Form

Sales Representative

First Last

Date Submitted*

Contact Name*

First Last

Contact Phone

Contact Email*

Project Name

Project Address

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

Name / Address to Return Information:

Technical Information

Please 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:

AFUE Rating:

Where Will the Ductwork be Located?

Duct 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:

Ceiling Type:

Ceiling Insulation Preference:

If "other" was selected for ceiling insulation preference, please describe:

Floor Type

Floor Type R-Value:

Window Frame Type:

If "other" was selected for window type, please describe:

Window Panes:

If "other" was selected for window panes, please describe:

Window Glazing:

If "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 Option

EnergyWise Master Class Dealer Residential Energy Analysis Fees:

For every additional 2,000 square feet add $100.00

Section 2: Smaller Home Special Pricing Option

In 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 Layout

All 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):

Rush Service: 3-Business Day Turnaround:

Emailed Plans Printing Fee:

If you've emailed your plans to us, a $20 in-house printing fee is required.
Email: analysis@energywisestructures.com

Total

$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 List

1. 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.

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