Electrical Service Request Form

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:

Phone
ext.
Alt Phone
ext.
Email

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:

Street #
Street Name
Unit / Apt. #
City
State
Zip Code

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

D. Tax Map Key Information:

Tax Map Key Number
(e.g. 1-1-1-333-333)
Lot #

E. Customer / Owner Name:

First Name
Middle Name
Last Name

Are you an existing customer?

Account #
(e.g. 4444-4444-333)
Meter #
(e.g. PX999999999) (if available)

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

Licensed Electrician
Architect
Other

G. Type of Request: (Select all applicable)

Application #

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.)

Description

Total

Total Connected (KVA)
Total Demand (KVA)
Total Generation (KW)
Total Demand (KVA)
Load will consist of: (select all applicable)

B. Building: (Provide square footage.)

Description

Total

Total Square Footage (Sq Ft)
Square Footage w/ AC (Sq Ft)

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

Equipment Type

Rating (HP/KW)

#Units

Total Load (rating x #units)

D. Services Needed & Need by Date:

Description

Services Needed?

Need by Date (mm/dd/yyyy)

Temporary / Construction Power
Permanent Service

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

A. Name to Appear on Bill:

Residential:

First Name
Middle Name
Last Name

Commercial: (Name of Business & Contact)

Are you an existing customer?
Account #
(e.g. 4444-4444-333)

B. Billing Contact Information:

Phone
ext.
Alt Phone
ext.
Email

C. Billing Address:

Street #
Street Name
Unit / Apt. #
City
State
Zip Code

D. Responsible Party Is: (Select 1)

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

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

A. Name to Appear on Bill:

Residential:

First Name
Middle Name
Last Name

Commercial: (Name of Business & Contact)

Are you an existing customer?
Account #
(e.g. 4444-4444-333)

B. Billing Contact Information:

Phone
ext.
Alt Phone
ext.
Email

C. Billing Address:

Street #
Street Name
Unit / Apt. #
City
State
Zip Code

D. Responsible Party Is: (Select 1)

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
Federal Tax ID no.
Hawaii General Excise Tax No.

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:

Send drawings as attachments via email to cidsr@hawaiianelectric.com.

Maximum file size is 15 MB.

Courier:

Send drawings by courier as follows:

Attention:
Customer Installations Department
Hawaiian Electric Company, Inc.
820 Ward Avenue
Honolulu, Hawaii 96814

FTP:

Send drawings via FTP at URL address: ftp://ftp.hei.com.

If you do not have a username and password, contact Michael Hahn at michael.hahn@hawaiianelectric.com.

Drag and drop files into the incoming folder.

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