Request for Residential Gas Service

Project Information

Project Location (Required)
City (Required)
County
Cross Streets
Tract(s)
Zip Code (Required)
Lot(s)

Application Information

(* Either a Social Security # or Tax ID # is REQUIRED due to ratepayer funded allowance credit requirements)

Responsible Party (As it should appear on the Contract) (Required)
* Social Security# (xxx-xx-xxxx)
* Tax ID
-
Day phone (w/Area Code)
( ) - -
Street Address (Required) (Include Apt/Suite, or Bldg Info - No P.O. Box)
City (Required)
State (Required)
Zip Code (Required)
Parent Company Name (if applicable)
Mailing Address (if different from street address)
City
State
Zip Code
Contact Name & Title (if different from applicant)
Day phone (w/Area Code)
( ) - -
Fax (w/Area Code)
( ) - -
Email Address of Responsible Party for Contract Delivery (Required)
Mobile phone 1 (w/Area Code)
( ) - -
Mobile phone 2 (w/Area Code)
( ) - -

Construction Contacts

(if different than Applicant such as Utility Consultants and/or Construction Trench Provider)

Name Title Email Address Day phone (w/Area Code) Mobile phone (w/Area Code)
( ) - - ( ) - -
( ) - - ( ) - -

Project Timeline

Requested Gas Facility (pipe, meter manifold, etc.) Installation Date (Required) Requested Meter To Be Set and Turned On Date
/ / (mm/dd/yyyy) / / (mm/dd/yyyy)

Construction Information

Gas Installation Requested Construction Type Installation Method
Gas Line to Structure w/Meter(s)
Sub-Division/Tract Dev
Meter(s) Only
Extend Stub(s) in Tract
Single Family
Condo/Townhomes
Apartments
Other
Gas Company Provided Gas Only Trench
Applicant Provided Gas Only Trench
Applicant Provided Joint Trench

Load Information

Planned number of Dwelling Units:

Planned number of Central or Community Facility Meters (Recreation Center, Pool Heater, Spa, Laundry Room, etc.):
Gas Appliance Quantity MBTU/Hr * Gas Appliance Quantity MBTU/Hr*
Gas Range (Cooktop) Clothes Dryer Stub
Gas Oven Fireplace Stub
Water Heater - Tank (standard) Patio Stub
Water Heater - Tankless Natural Gas Powered Spa/Pool Heater
Space Heating - Furnace, Wall Heater, etc. Natural Gas Powered Air Conditioning
* Common Residential Equipment Connected Load Requirements (MBTU/Hour)
Appliance Type Gas Input MBTU/Hr
Cooking - Range Top 30-80
Cooking - Oven 30-50
Water Heating - Tank 30 to 50 Gal 30-50
Water Heating - Tankless or On-Demand 120-199
Space Heating - Standard Furnace 80-120
Space Heating - Hydronic Boiler 60-100
Space/Water Heating Combo - Hydronic Unit 80-150
Laundry - Clothes Dryer 30-50
Pool/Spa Heater 250-500
Gas Fireplace 20-80
Gas BBQ 20-60
Gas Lights 2-5
Other Gas Appliances (specify):     Please provide information on: Applicant Design

Applicant Installation Options

Applicant Install - Rule 20 section G allows the applicant to receive a competitive gas installation bid, if desired. If the AI bid option is selected, a gas line extension may be installed by the Applicant's SoCalGas certified and approved Installer and installed per SoCalGas design and installation specifications.

If selected, the Applicant is responsible for, but not limited to, all applicable permits, paving, trenching, approved material, and SoCalGas inspection. SoCalGas does not refer or recommend Applicant Installer's to Applicants due to anti-competitive preferential treatment rules.

Please Select One (Required) : Option 1 - SoCalGas Install       Option 2 - Request Applicant Install Competitive Bid Information

Application Submitted By: Title: Date: / / (mm/dd/yyyy)

Please provide an email address to receive a copy of the request: