Contractor
Phone
Job Name
Date
Voltage (Circle)
Fuel
Elec. Service
NET SQUARE FOOTAGE
GENERAL LOADS
General Lighting and General Use Receptacles
Branch Circuits (1500 VA/ft²)
Small Appliance Circuits (20 Amp)
Laundry Circuits
Fixed Appliances
Well
Sump Pump
Freezer
Microwave (Not counter-top model)
Disposal
Dishwasher
Range (See Table 220.55 for multiple cooking appliances)
Wall-Mounted Oven
Counter-Mounted Cooking Surface
Water Heater
Clothes Dryer
Garage Door Opener
Septic Grinder
Other (list)
Total General Loads
HEAT / A-C LOAD
A-C / Cooling Equipment
Heat Pump
• Compressor (if not included as A-C)
• Supplemental Electric Heat
Electric Space Heating
• Less than 4 separately controlled units
• 4 or more separately controlled units
System With Continuous Nameplate Load
Largest Heat / A-C Load (VA) VA kW
GENERAL LOADS
• 1st 10 kW of General Loads 100% kW
• Remaining General Loads 40% kW
CALCULATED GENERAL LOAD kW
LARGEST HEAT / A-C LOAD 100% kW
TOTAL CALCULATED LOAD (Net General Loads + Heat/A-C Load)
22
Worksheet — NEC 2011, 220 Part IV
Location
240V -1Ø
100 Amp
Qty
Email
Fax
NG
LPV
200 Amp
400 Amp
Rating (Load)
Factor
Loads (VA)
3 VA/ft²
100%
1500
100%
1500
100%
Full Current Rating
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
65%
65%
40%
100%
100%
40%
Other
Loads (kW)
(VA ÷
1,000)
VA
kW
kW
kW
kW
kW
kW