Building Energy Performance Assessment Questionnaire Form
Complete this assessment to evaluate the energy performance and efficiency features of your building.
Building Type
*
Please Select
Residential
Commercial
Industrial
Institutional
Other
Year of Construction
*
Primary Heating System
*
Gas
Electric
Oil
Heat Pump
Other
How would you rate the building’s insulation?
*
1
2
3
4
5
Window Type
*
Single-glazed
Double-glazed
Triple-glazed
Mixed/Other
Lighting Efficiency
*
1
2
3
4
5
Does the building use renewable energy sources?
*
Yes
No
Partially
Please rate the following aspects of building energy performance:
*
Rows
Poor
Fair
Good
Excellent
Heating Efficiency
1
2
3
4
Cooling Efficiency
5
6
7
8
Hot Water System
9
10
11
12
Ventilation
13
14
15
16
Estimated Annual Energy Consumption (kWh)
*
Additional Comments or Notes
Submit Assessment
Should be Empty: