Name:

Current Street Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Fax Number:

E-mail Address:

Street Address:

City:

State:

Zip:

Nearest Major Intersection:

	Single Family
	Condominiums
	Multi-Family
	Apartments
	Commercial
	PUD
	Multi-Story Building
	Detached Structure (like a garage)
Other:

If "Multi-Family" or "Apartments", specify # of units:

Number of Bed, Bath & Garage size (for example "4-3-3")

Approximate Age:

Approximate Square Feet:

# of Stories:

Detached Structures? i.e. Garages etc.

Overall Condition (How well has it been maintained):
	Good
	Fair
	Poor
Building is currently:
	Vacant
	Occupied

Crawl Space?

	ASHI Contract Home Inspection
	Pool
	Spa
	Sea Wall
	Termite
	Mold Inspection
	Crawl Space
	New Home 6 Phase Construction
	Custom
	1 Year Warranty (New Construction)
	Consulting Services
	Commercial Building
	Radon Test
	Lead Test
	Dock
	Structure Only
	Manufactured Home
	Roof Only
	Video
	Engineering Services
	Service Charge
Other:

if "Custom" - please specify:

Do you plan on attending the Inspection? (SunCoastInspections.com highly recommends it)

Was anything disclosed by the seller?

If so - details:

Verification:
	CHECKING THIS BOX VERIFIES BUYER (CLIENT'S) ORDERED THE INSPECTION AS STATED.
*	Suncoast Inspections.com reserves the right to adjust the inspection fee if condition is misrepresented.

How would you like us to contact you?

	By Email
	By Phone