Name

Street

City

State

Zip

Phone

Fax

Email

Type of Building:

Residential

Commercial

Approximate building size

square ft.

Approximate lot size

acres

Topography:

Sloping

Level

Current Heating and Cooling System:

Forced Air

Radiator

Baseboard

Other

Fuel Sources:

Gas

   Oil 

Electric Heat Pump

Alternative Fuel Sources:

Solar

Geo Thermal

Wind

Insulation in Place:

Double or triple pane windows

Single pane

Attic

R rating

Floors

R rating

Walls

R rating

Ceilings

R rating

Doors

R rating

Lighting Systems:

Incandescent

Flourescent

LED

Other

Special Features or Amenities:

In-ground swimming pool

Room additions

Other

Comments