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A. Company Name:
Company Name
B. Requestor Name:
First Name
Middle Name
Last Name
Street #
Street Name
Unit / Apt. #
City
State
Zipcode
C. Contact Information:
Phone	Ext.
Type
Other
Alt. Phone	Ext.
Type
Other
Email
D. Requestor Is:
Requestor is
Other

A. Project Name:
Project Name
B. Project Address / Location:
Street #
Street Name
Unit / Apt. #
City
State
Zipcode
C. City Permit #:
City Permit #
D. Tax Map Key Information:
Tax Map Key Number
Lot #
E. Customer / Owner Name:
First Name
Middle Name
Last Name
Are you an existing customer?
Account #
Meter #
F. Consultant / Licensed Contractor:
Licensed Electrician
Architect
Other
G. Type of Request:
Type of Request
Application #
Other
H. Type of Project:
Type of Project


Other
I. Type of Service:
A.
B.
C.
J. Voltage:
A.
B.
C.
D.

A. Load / Generation:
Total Connected (KVA)
Total Demand (KVA)
Total Generation (KW)
Total Demand (KVA)
Load will consist of: (select all applicable)
Other
B. Building:
Total Square Footage (Sq Ft)
Square Footage w/ AC (Sq Ft)
C. Equipment:
Equipment Type	Rating (HP/KW) #Units Total Load (rating x #units)


	;
D. Services Needed & Need by Date:
Temporary / Construction Power
Need by Date (mm/dd/yyyy)
Permanent Service
Need by Date (mm/dd/yyyy)

A. Name to Appear on Bill:
Residential First Name:
Residential Middle Name:
Residential Last Name:
Commercial: (Name of Business & Contact)
Are you an existing customer?
Account #
B. Billing Contact Information:
Phone	Ext.
Type
Other
Alt. Phone	Ext.
Type
Other
Email
C. Billing Address:
Street #
Street Name
Unit / Apt. #
City
State
Zipcode
D. Responsible Party Is:
Responsible Party Is
Other
E. For New Residential Customers:
Occupation of party responsible for bill
Employer
Years employed
Spouse's Name
F. For New Commercial Customers:
Type of business
Number of years in business
Tax ID no.
Hawaii General Excise Tax No.
Select 1
Other

A. Name to Appear on Bill:
Residential First Name:
Residential Middle Name:
Residential Last Name:
Commercial: (Name of Business & Contact)
Are you an existing customer?
Account #
B. Billing Contact Information:
Phone	Ext.
Type
Other
Alt. Phone	Ext.
Type
Other
Email
C. Billing Address:
Street #
Street Name
Unit / Apt. #
City
State
Zipcode
D. Responsible Party Is:
Responsible Party Is
Other
E. For New Residential Customers:
Occupation of party responsible for bill
Employer
Years employed
Spouse's Name
F. For New Commercial Customers:
Type of business
Number of years in business
Tax ID no.
Hawaii General Excise Tax No.
Select 1
Other

A. Indicate if other / future source of power will be utilized or is being considered:
Indicate if other / future source of power will be utilized or is being considered:
Other

A. Select All Items to be Submitted:
Select All Items to be Submitted
Other
B. Type of Drawings:
Type of Drawings
Other
C. Drawings will be Sent Via:
Drawings will be Sent Via
Other

I. Requestor: (Party who will provide project information and updates to Hawaiian Electric Company)

A. Company Name: (Indicate Company Name if you are a consultant, contractor, electrician, or architect.)

B. Requestor Name:

C. Contact Information:

D. Requestor Is: (Select 1)

II. Project Information:

A. Project Name: (Include Project Name if applicable. Attach separate sheet if applying for multiple lots and include Subdivision Name, Lot#, Address, TMK, C&C Permit#.)

B. Project Address / Location:

C. City Permit #: (Additional costs may apply for service requests without permits. See "Basic Cost Information.")

D. Tax Map Key Information:

E. Customer / Owner Name:

Are you an existing customer?

F. Consultant / Licensed Contractor: (First, Middle Initial, Last)

G. Type of Request: (Select all applicable)

H. Type of Project: (Select 1)

I. Type of Service: (Complete A-C)

A.

B.

C.

J. Voltage: (Complete A-C. Complete D if applicable)

A.

B.

C.

D.

III. Alternate Power:

A. Indicate if other / future source of power will be utilized or is being considered:

IV. Consultant Requests Only: (Complete this section)

A. Load / Generation: (Provide load or generation information.)

B. Building: (Provide square footage.)

C. Equipment: List equipment type & rating (e.g., pump, 25 HP, elevator, etc. Attach separate sheet for additional equipment.)

D. Services Needed & Need by Date:

V. Billing Information: Energy Usage (Party responsible for energy usage after meter is installed) (If available)

A. Name to Appear on Bill:

Residential:

Commercial:(Name of Business & Contact)

Are you an existing customer?

B. Billing Contact Information:

C. Billing Address:

D. Responsible Party Is: (Select 1)

E. For New Residential Customers:

F. For New Commercial Customers:

Select 1

VI. Billing Information: Construction Cost (Party responsible for construction costs) (If available)

If Same Above, Check Here:

A. Name to Appear on Bill:

Residential:

Commercial: (Name of Business & Contact)

Are you an existing customer?

B. Billing Contact Information:

C. Billing Address:

D. Responsible Party Is: (Select 1)

E. For New Residential Customers:

F. For New Commercial Customers:

Select 1

VII. Submittals: (Items that are being submitted to Hawaiian Electric Company)

A. Select All Items to be Submitted:

B. Type of Drawings:

C. Drawings will be Sent Via:

Email:

Courier:

FTP:

VIII. Remarks: Please provide additional information that will help us complete your request.

I. Requestor: (Party who will provide project information and updates to Hawaiian Electric Company)

II. PROJECT INFORMATION:

III. ALTERNATE POWER:

IV. Consultant Requests Only: (Complete this section)

V. Billing Information: Energy Usage (Party responsible for energy usage after meter is installed) (If available)

VI. Billing Information: Construction Cost (Party responsible for construction costs) (If available)

VII. Submittals: (Items that are being submitted to Hawaiian Electric Company)

VIII. Remarks: Please provide additional information that will help us complete your request.

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