211 Walnut Street
It will only take a few minutes to complete this form. Gather any photos and other documents you might need before you begin. If you exit the form without submitting, you will have to start over.
If you need to provide additional information after submitting the questionnaire, feel free to send such items via email to firstname.lastname@example.org
Assessment Contact Information:
Phone: (920) 886-6115
Mailing Address (If different than property address)
Projects are assumed to be 100% complete as of January 1 unless you indicate a partial complete project.
If the project will not be completed by January 1, fill out all requested information based on the expected final result, and estimate the percent complete as of January 1.
Below, please indicate the room count of the entire dwelling before and after project is complete. If a room or characteristic listed does not exist in your home, please indicate this with the number "0."
Bedrooms - total number of seperate rooms designed to be used as bedrooms. If a room was designed to be a bedroom but is being used for some other purpose such as an office, it must be included in the bedroom count, not the "other room" count.
Full Bath - total number of 3-fixture bathrooms (sink, toilet, bathing unit)
Half Bath - total number of 2-fixture bathrooms (sink and toilet only)
Number of Bedrooms
Number of Full Baths
Number of Half Baths
Number of Fireplaces
Number of Egress Windows
Number of Other Rooms
My project is a (check all that apply)
Was egress window installed in a previously finished area?
What was the effect of the foundation repair/egress window?
Egress window added?
Indicate rooms affected - check all that apply
Describe finish materials used.
Common materials used for interior remodel and basement finish projects.
Flooring: carpet, hardwood, LVT (luxury vinyl tile), sheet vinyl, ceramic tile/stone
Cabinetry: Type: custom, semi-custom, stock
Style: flat panel, raised panel, glass front, Euro-style
Material: wood (oak, maple, cherry, etc.), Medium Density Fiberboard (MDF), pressboard/particle board, plywood
Countertops: Laminate, solid surface/Corian, granite/stone, marble/quartz, concrete, tile
Doors: hollow core, solid core; flat panel, raised panel; French door; barn-style door
Trim: Baseboard, wainscoting, crown molding
Ceiling type: sheet rock/drywall/plaster, drop ceiling
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