ABNA- Structure Condition Survey 09a

• Conducted on

  Date

• Residents Full Name

• Site No.

• Location
  Address

• Inspected by

• Document No. 16-6233

• Type of Structure

  Residential

  Commercial

• Property Sketch Photo

  Media

• Property Description

Exterior

Roof

• Roof Photo(s)

  Media

• Roof description

Exterior Profile

• Profile Photo(s)

  Media

• Profile description

Grounds

• Ground Photo(s)

  Media

• Grounds description

Other Area

• Other Area Photo(s)

  Media

• Other Area description

• Exterior Over All General Conditions:

  Significant

  Marginal

  Superficial

  N/A

• Exterior Summary

Interior Room 01

• ROOM TITLE / NAME

WALL(s)

• Wall Photo(s)

  Media

• Wall description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 01

Interior Rooms 02

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 02

Interior Room 03

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 03

Interior Room 04

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 04

Interior Room 05

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 05

Interior Room 06

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 06

Interior Room 07

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 07

Interior Rooms 08

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 08

Interior Room 09

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 09

Interior Room 10

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 10

Interior Room 11

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 11

Interior Room 12

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 12

Interior Room 13

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 13

Interior Room 14

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 14

Interior Room 15

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 15

Interior Room 16

• ROOM TITLE / NAME

WALL(s)

• Add Wall Photo(s)

  Media

• Wall Photo description

CEILING

• Add Ceiling Photo(s)

  Media

• Ceiling Photo description

FLOORING

• Add Flooring Photo(s)

  Media

• Flooring Photo description

OTHER AREA

• Add Other Area Photo(s)

  Media

• Other Area Photo Description

• GENERAL CONDITIONS of this Interior:

  Significant

  Marginal

  Superficial

  N/A

• General Interior Room SUMMARY 16

• Name of Respondent(s)

• Please check as applicable:

• 01. Are you the current resident?

  Yes

  No

  N/A

• Full name of Resident

• 02. Has the roof been installed or repaired in the last 10 years?

  Yes

  No

  N/A

• When was this? And describe the repair.

• 03. Check the box, if you are aware of any cracks in the fondation?

• Describe in detail, with approximate location and repair method if applicable.

• 04. Check the box, if you are you aware of any signs of settling, inside or outside the building?

• Describe in detail, with approximate location and repair method if applicable.

• 05. Check the box, if you are aware of any sewer back-ups or flooding on the property?

• Describe in detail, with approximate location and repair method if applicable.

• 06. Additional areas of concern (if applicable)?

• 07. Additional comments

• By signing below I confirm that the information provided is true and factual to the best of my knowledge at such time.

• Signature

  Sign