EVSE Technical Assistance Application

EVSE Technical Assistance Application

Enter the first name of the contact person for this application.*

Enter the last name of the contact person for this application.*

Pacific Power customer account number*

This should be a number in the format 00000000-000 0

Property Name/Company Name*

Project Contact Email*

Project Contact Phone Number*

Enter the contact's 10-digit telephone number

Phone

Alternative Phone Number

Optional

Phone

Street / Installation Address

Project Street Address*

Enter the address where charging stations will be installed. Please Note: the address must be within Pacific Power service territory.

Unit/Apt. #

Project City*

Project State*

Select

Project Address Zip Code*

Property Type*

Choose one: Workplace includes sites where people work, such as an office complex. Public parking includes retail centers and parking areas used specifically for public parking. Fleet sites include parking areas reserved for fleet usage.

Select

Check below if the mailing address is different from the property address listed above.

Mailing Address Street*

Mailing Street Address (optional)

Mailing Address City*

Mailing Address State*

Mailing Address Zip Code*

Site Information

Number of EV charging ports desired?

For fleets, please describe the types of vehicles included in your electrification plan (e.g. step & panel vans, school buses, forklifts, etc.).

Do you currently have EV chargers in your parking areas?

Select

Parking Type

Select

Interested in multiple locations?

Select

How were they referred?*

Select

Please describe your preferred charger location.

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