Homeowner Inspection Agreement

HERS
Home Energy Score
ELEM3NTS Assessments
Rebate Forms (A copy of the PG&E bill is required)

Customer Information

Property Owner’s Full Name:

PG&E Account Holder’s Full Name:

PG&E Account No:

Street Address (Where project was completed):

City:

ZIP:

County:

Telephone Number:

Email Address:

Date:

Signature:

By checking this box I authorize ELEM3NTS to perform inspection services at my house. During the inspection, ELEM3NTS shall be allowed: (a) full access to my home or any testing location, including but not limited, to all rooms, spaces, and equipment, (b) to take any photographs in my home, (c) to take any measurements or conduct testing necessary for the inspection services requested, (d) to share any information obtained during the inspection services, including the photographs taken in my home, and (e) use any information obtained by ELEM3NTS during the inspection process to obtain government permits, rebates or a home energy score, and to prove compliance with Title 24 of the California Code of Regulation.

The inspection and any and all services provided by ELEM3NTS shall be performed according to ELEM3NTS' Terms of Use and Privacy policy that may be found HERE, which may be viewed at all times on this website. By clicking on this box, you agree that you have read ELEM3NTS' Terms of Use and Privacy Policy and you agree with their terms.

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