Inspection Request Form
Printable Version
Client
Information
Name_________________________________________
Address
_____________________________________
City
_____________________________________
State, Zip _____________
_____________
Home Phone _________________________
Work Phone _________________________
Cell Phone _________________________
Fax: ___________________________
Email _________________________________
To be Inspected
Address
_____________________________________
City
_____________________________________
State, Zip _____________
_____________
Agent Information
Agent
Name_____________________________________
Agent
Code_____________________________________
Agent
Address_____________________________________
Company_____________________________________
Phone___________________________________________
Email_____________________________________
Fax_____________________________________
Cell
Phone_____________________________________
City, State,
Zip_____________________________________
Heated Square
Footage_____________________________________
Total Square
Footage_____________________________________
Deadline Inspection
Date__________________________________________
Inspection
Time_____________________________________
Age of Home_________
Type of Structure:
Please check
Beach house on piling/ open underneath
Beach house on piling/1/3 storage under
Beach house on piling/ full garage/storage
Condo
Ranch style home/ slab
Ranch style home/ crawlspace
Single wide home
Single wide home with bedroom addition
Double wide home
Town Home / slab
Town Home / crawlspace
Duplex / both sides
Duplex / one side
Condo
Patio Home/slab
Patio Home/crawlspace
Commercial Office
Commercial Building/ Slab
Commercial Building/
Crawlspace
Other:
Other to be inspected:
Please check
Detached building
Detached one car garage
Detached two car garage
Detached three car garage
Attached one car garage
Attached two car garage
Attached three car garage
Swimming Pool Decking or Patio
Swimming Pool & Decking / Patio
Combination of the above/ please contact
Method of payment:
Please check
Check to be mailed with order
Check on day of inspection
By check or credit card net 10 days from
By Visa
By Master Card
By Discover
Cash
On Closing date (understanding additional
$40 closing fee)
Other:
Other services:
Please check
Mold / air testing
Dust / allergy testing
Stucco Screening
Radon Screening
Water test–Bacteria, Total Coliform–E coli
Water test-Chemical/Bacteria, Coliform - E
coli - Lead-Nitrate - PH-Iron
Water test-Complete Test, all above +
Alkalinity – Chlorine- Copper Chlorine-Clarity-Hardness
Other:
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