Atch 4 - SCE Customer Project Information Sheet -.pdf

04/15/2022 - Version 7.0 P a g e | 1 DS-111

Customer/Project Information Sheet

Date Received by SCE:

Individual or Business Name:

(Customer / Developer – Tract DBA or LLC )

Address: Email Address:

City: State: Zip Code:

Attn: Phone No:

Legal Contact: Phone No:

(Individual responsible for signing contract, paying fees and receiving potential refunds) Address: Email Address:

City: State: Zip Code:

Primary Field / Site Superintendent / Job Contact:

Relationship to Project: Phone No. (Direct Lines ONLY):

E-mail Address:

FAX No:

Fax No:

Project Address:

City: State: Zip Code:

TG Map # or GPS: Major Cross Street:

Detailed Project Information

Residential: Commercial: Industrial: Agricultural:

Indoor Cultivation

Mixed-Light Cultivation

Service Requested: Overhead: Underground:

Tract: Lot(s):

Is this project subject to Buy America Compliance? Yes No Temporary Service Required: Yes No

Approximate start work date for SCE crews: Your Construction Start Date:

Approximate date you would like the job completed and energized:

Scope of Project:

Panel Size (amps): Service Voltage/Phase:

Total Tons of A/C: Total # of A/C Units: Largest A/C Unit (tons):

Total HP of Pumps: Total # of Pump Units: Largest Pump (HP):

Installing Gas or Electric: Heater: Water Heater: Stove:

Clothes Dryer: Gas Meter to be Installed at Property: Oven:

Square Footage of Buildings (if multiple buildings give all footages):

Homes over 5000 sq. ft larger lots require a Load Schedule. Please contact your electrician for assistance.

Solar or Generation Equipment to be installed (If yes, please attach additional descriptions/specifications): Yes No

Is this project being completed on or near a CalTrans Right Of Way (ROW): Yes No

04/15/2022 - Version 7.0 P a g e | 2 DS-111

Electric Vehicle Charging - Mandatory. Please select one option.

I am interested in one of SCE’s Charge Ready EV infrastructure programs.

• Complete Sections A and B below.

• Refer to Additional EV infrastructure program information or Submit a question, I am NOT interested in one of SCE’s Charge Ready EV infrastructure programs, however I am interested in installing my commercial EV project using Tariff Rule 15, 16, or 29.

• Please email tepmcommercialev@sce.com for additional submittal requirements.

Section A

Electric Vehicle Passenger

• Refer to Additional Information or Submit a question Medium/Heavy Duty

• Refer to Additional Information or Submit a question

Charge Station Plug-In Electric Vehicle

(PEV)

Section B

EV Panel Size & Voltage:

Main breaker rating:

Will the new panel serve any load other than the EV load? Number of Ports:

kW of each Port: Will there be load-side management? Future EV expansion or growth at the site?

https://www.sce.com/evbusiness/overview mailto:chargeready@sce.com https://edisonintl.sharepoint.com/teams/Public/TM2/Shared%20Documents/Forms/AllItems.aspx?id=%2Fteams%2FPublic%2FTM2%2FShared%20Documents%2FPublic%2FRegulatory%2FTariff%2DSCE%20Tariff%20Books%2FElectric%2FRules&viewid=c9868ae1%2Df1cd%2D43b6%2Da712%2Dd734ff79e266 mailto:tepmcommercialev@sce.com https://www.sce.com/evbusiness/chargeready mailto:chargeready@sce.com https://crt.sce.com/overview mailto:chargereadytransport@sce.com