3504 201G Gas Application Non ResidentialNumber of Units
Equipment
Total Unit BTUs# of MetersDesired Delivery Pressure:
Unit Square FootageBusiness Type
Total BTUs
Number of Meters for Building Building Square Footage
MAIN UNIT INFO:
Equipment Total BTUs Equipment Total BTUs
Equipment Total BTUs Equipment Total BTUs Equipment Total BTUs
Unit Label (ie: A 101)
Unit Label (ie: A 101)
Unit Label (ie: A 101)
Business Type
Business Type
Business Type
Business Type
Business Type Sq. Footage
Sq. Footage
Sq. Footage
Sq. Footage
Sq. Footage
Delivery Pressure:
Delivery Pressure:
Delivery Pressure:
Delivery Pressure:
Delivery Pressure:
Total Unit BTUs
Total Unit BTUs
Total Unit BTUs
Total Unit BTUs
Total Unit BTUs
6” Water Column
[1] The above information allows the Project Manager to understand the project scope. If your loads are above 1400 CP, the Project Manager will also
provide you a customer equipment worksheet. This worksheet will be required for the project design.
Non-Residential Gas Service Application
Use for buildings where all or a portion of which are intended for commercial, retail, or general public activities. This includes
commercial back up generators, barns and garage shops (outbuildings). For projects with multiple buildings a separate application is
required for each building. A site plan must be submitted with this application in order to be processed.
2 PSI Other:
Project Name
*Contractor Phone*Contractor Name
*Zip Code*City*Project Address (Parcel Number if Address is not Assigned)
Email*PhoneProject Role*Project Point of Contact
Building Permit Number (If Available)
Email*Phone*Property Owner Name
*Construction Charges Billing Address
Contact Name*Party Responsible for Project Construction Charges
*Party Responsible for On-Going Service Usage Charges Upon Completion of Project Construction:
Construction Charges Contact Email*Construction Charges Contact Phone
*State*City *Zip Code
Property Owner Contractor
Project Role
Unit Label (ie: A 101)
PROJECT INFORMATION
PROPERTY OWNER INFORMATION
BILLING INFORMATION
SERVICE INFORMATION[1]
For projects with only one unit/meter, only complete the main unit information section. For projects with multiple units/meters complete the main unit section for the unit with the lowest unit number and use additional unit section for the remaining units.
Unit Label (ie: A 101)
ADDITIONAL UNITS
ADDITIONAL UNITS
ADDITIONAL UNITS
ADDITIONAL UNITS
Unit Label (ie: A 101)ADDITIONAL UNITS
07/23
I understand this application and the information provided herein is a preliminary step to obtain information about natural gas service and that it is
not an agreement to use gas or have gas installed. If I decide to have gas installed, a gas contract will be sent for signature and that agreement will
be the official notice to proceed with gas installation. For more information about PSE’s privacy policy, please visit
https://www.pse.com/pages/privacy
Signature (Typed Signature is Acceptable)Date
*Will existing gas facilities at the location require relocation or removal?Yes (Mark on Site Plan) No
Please provide any other pertinent information related to the job:
Please describe what facilities will be relocated/removed:
ADDITIONAL PROJECT INFORMATION
MOVING EXISTING FACILITIES
I understand that completing this box constitutes a legal and binding signature confirming that I acknowledge and agree to the above terms.
Electronic application submission via the above button or as an attachment to NewServiceApplications@pse.com is
the preferred and most efficient method for application submission. If that is not possible, you may mail your
application and site plan.
Puget Sound Energy (CCS)
3130 S. 38th St
Tacoma, WA 98409
07/23