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Additional Notes
FINANCIAL
GIVE US SOME INFORMATION ABOUT YOUR CURRENT PROPERTY
Current Property Value?
Cost per square foot?
Land or current first lien payoff amount?
Is the Land Currently Financed?
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Yes
No
If YES, Financed amount
Projected budget cost amount
Loan Amount Request
Any other green homes in surrounding area?
Yes
No
I'm not sure
If known, How much are properties selling for per sq. ft.?
Additional Information
GREEN BUILDER
TELL US ABOUT YOUR GREEN BUILDER
Name, Address and Phone of Builder
Is the project being built by a qualified – certified builder-contractor?
Yes
No
I'm not sure
Do you need a green builder referral?
Yes
No
I'm not sure
Additional Information
PROJECT INFORMATION
GIVE US INFORMATION ABOUT THE PROJECT YOU WANT TO MOVE FORWARD WITH
Tell us about your project needs
Type of Property
Purchase
Refinance-Retrofit
Ground up Construction
Tear Down- Slab-Studs
Green Upgrade Type
Light Energy Efficiency
Deep Energy Efficiency
Near-Net Zero
Net-Zero (Excess power generation)
New Construction (Is the land owned free and clear)
GREEN FEATURES
TELL US ABOUT THE GREEN FEATURES OF THE PROPERTY
Type of Label
DOE Challenge Home
Passive House
Zero-net
Energy Star
HERS Rating
Type of Renewable Upgrades
Solar
Geothermal
Rainwater Harvesting
Solar Hot Water
If Rainwater is checked, choose one
Sole Source of Water
with Well Water
Connected to City Water
If Solar is checked Solar kW (size) and Manufacturer
RATING
Meets or Exceeds
IECC 2015
ICC 700 Code
ICC-700 National Green Building Standard Certified:
Bronze
Silver
Gold
Emerald
LEED
Certified
Silver
Gold
Platinum
ENERGY EFFICIENCY
Has an Energy Audit been performed?
Yes
No
Attach Energy Audit
Type of Green Upgrades (Check all that apply)
Energy efficient-(HERS 70-50)
Deep Retrofit (HERS 50-30)
Zero-net (HERS 30 to minus 0)
Energy Rating Home Energy Score (HES)
Attach Home Energy Certification
HVAC
High Efficiency HVAC
Heat Pump
Thermostat/Controllers
Passive Solar
Programmable Thermostat
Geothermal
Not Sure
Insulation
Fiberglass Blown In
Foam Insulation
Cellulose
Fiberglass Batt Insulation
HERS Insulation Installed
HERS Insulation Installed Rating
1
2
3
Known Incentives
Federal
State
Local
Thank you for taking the time to fill out the form with Green Energy Money. Please add any additional information we may need to know to help you with your request. We will contact your shortly if we need additional information, and to learn more about your project!
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