2025-2027 Wood Stove Change-out Application This is the web form for the 2025-2027 Wood Stove Change-out Program made available by the Spokane Clean Air Agency. "*" indicates required fields Step 1 of 4 25% X/TwitterThis field is for validation purposes and should be left unchanged.Home Owner Information (if home is a rental, owner must apply)Owner's Full Name* First Last Email* Phone*Owner's Address (physical address where changeout will be performed)* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Owner's Mailing Address (if different than physical address) Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code If for a rental (must currently be occupied) list address Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Future DeviceWhich type of device are you interested in upgrading to?* Electric Freestanding Stove Electric Fireplace Insert Wood Freestanding Stove Wood Fireplace Insert Pellet Freestanding Stove Pellet Insert Gas Freestanding Stove Gas Fireplace Insert Ductless Heat Pump I’m not sure yet If replacing your wood insert, it must be replaced with an insert (electric, wood, pellet or gas).Current Wood Heating DeviceWhat type of home wood heating device do you have installed that you want to replace under this program?* Wood Burning Stove – Free standing Wood Burning Stove – Insert Manufactured Fireplace- Similar to an Insert Note: Fireplaces don’t qualify; pellet devices don’t qualify. Wood heaters in garages, outbuildings, etc., don’t qualify. Manfacturer/Make/Model*Year Manufactured*To qualify, your installed, operational wood stove/ insert must be at least 20 years old or non-EPA certified (i.e. a homemade device). Additional InformationHow did you hear about this program?*Check all that apply Business that sells heating devices Radio, TV, or newspaper Social media Friend/Family member Other If other, please describe how you heard about this programWhy are you interested in replacing your old wood burning stove or insert?*Check all that apply Not satisfied with current device Remodeling Clean air Saving money Other During a typical heating season, how many days per week do you use your wood stove/insert?* 1-3 days 4-6 days Every day Weekends only On the days you use your wood stove/insert, how many hours do you typically operate it?* Less than 6 hours 6-12 hours 12-15 hours All day Do you purchase your firewood?* Yes No If no, do you harvest your own wood?* Yes No During a typical heating season, approximately how many cords* of wood do you burn?**A full cord of wood stacked measures 4 feet deep by 4 feet high by 8 feet long.What is your primary heat source?* Oil Electric Natural gas Propane Other Do you have natural gas piped to your home?* Yes No Grant Agreement*Per the grant criteria, please check the box if you attest to the following: If I select a natural gas device, I understand I am only eligible for the incentive if natural gas is the most affordable option for me. I agree to the grant criteria. Sign and submit this form with a photo of your existing deviceBy signing below, I agree that the information I’ve provided on this application is accurate. I have read, understand, and I agree to all of the terms as listed on the program web page. I will submit this application with a photo of my existing, installed, and operational wood stove or wood stove insert. Full Name* First Last Today's Date* Month Day Year Photo of Existing Device*File limit: 10MB Drop files here or Select files Max. file size: 10 MB. CAPTCHAUntitled Δ
