Title Page

  • Site conducted

  • Client

  • Conducted on

  • Prepared by

  • Occupant's Name

  • Address

  • Home Facing(direction) N-S-E-W

  • Number of bedroom

  • Building Type(i.e. mobile, bungalow

  • Year Built

Exterior

  • Skirting (mobile homes)

  • Anchorage (mobile homes)

  • Water storage / Septic tanks / Oil Tank

  • Driveways / Parking

  • Walkways

  • Grade (Around Foundation)

  • Foundation (Above Grade)

  • Cladding / Wall Finish

  • Vent Hoods, Trim

  • Flashing (Windows / Doors / Siding / Wall Finish)

  • Soffits / Fascia / Flashing

  • Electrical outlet

  • Hose Bib

  • Meter Socket/Mast

  • Eavestroughs / Downspouts / Splashpads

  • Roofing

  • Roof Vents, Plumbing Vents, Flashings

  • Chimney

  • Attic Access

  • Attic insulation

  • Attic ventilation

Main Entrance

  • Location

  • Entrance door

  • Hand/Guard Rail

  • Steps/Landings

  • Balcony Deck

  • Other

Secondary Entrance

  • Location

  • Entrance Doors

  • Hand/Guard Rails

  • Steps/ Landings

  • Balcony/Deck

  • Other

Basement/Crawlspace

  • Basement / Crawl Space Floor

  • Perimeter/Rim Joist Insulation

  • Foundation Walls / Grade beam

  • Columns / Beams / Joists

  • Stairs / Handrails / Entrance

  • Ventilation

  • Evidence of Water / Moisture Infiltration

  • Windows (with # to be replaced)

  • Fixtures

  • Switches / Receptacles

  • Other

Systems – Heat/Ventilation

  • Primary Heat Source - LIST AGE, FUEL TYPE & BTU'S

  • Secondary Heat Source (if applicable) – LIST AGE, FUEL TYPE, BTU'S

  • Date Last Serviced (if known)

  • Heat Distribution System

  • HRV/ Air Exchanger

  • Clearance to Combustibles

  • Other

Systems – Plumbing/Sewer

  • Sump Pump / Pit

  • Water / Sewage pumps

  • Hot Water Tank – LIST AGE, SIZE

  • Drain / Supply lines

  • Other

Systems – Electrical

  • Smoke Detector / CO Detector

  • Electrical Panel

  • Other

Main entrance/Porch area

  • Wall Finish

  • Flooring/Subfloor

  • Windows

  • Receptacles / switches

  • Light fixtures

  • Ceiling Finish

  • Other

Kitchen

  • Cabinets/Countertops / Backsplash

  • Light fixtures

  • Sink / Faucets

  • Flooring / Subfloor

  • Wall Finish

  • Ceiling Finish

  • Windows (with # to be replaced)

  • Receptacles / Switches

  • GFCI

  • Other

Living Room and Hallway

  • Wall Finish

  • Flooring/Subfloor

  • Windows (with # to be replaced)

  • Light fixtures

  • Switches / Receptacles

  • Ceiling Finish

  • Door

Bathroom 1

  • Location

  • Vanity

  • Sink / Faucet

  • GFCI Plug

  • Water Closet

  • Tub / Shower / Faucets

  • Tub Surround / Enclosure

  • Wall Finish

  • Ceiling Finish

  • Exhaust Fan

  • Flooring/Subfloor

  • Windows (with # to be replaced)

  • Light fixtures/switches

  • Other

Bathroom 2

  • Location

  • Vanity

  • Sink / Faucet

  • GFCI Plug

  • Water Closet

  • Tub / Shower / Faucets

  • Tub Surround / Enclosure

  • Wall Finish

  • Ceiling Finish

  • Exhaust Fan

  • Flooring/Subfloor

  • Windows (with # to be replaced)

  • Light fixtures/switches/

  • Other

Bathroom 3

  • Location

  • Vanity

  • Sink / Faucet

  • GFCI Plug

  • Water Closet

  • Tub / Shower / Faucets

  • Tub Surround / Enclosure

  • Wall Finish

  • Ceiling Finish

  • Exhaust Fan

  • Flooring/Subfloor

  • Windows (with # to be replaced)

  • Light fixtures/switches

  • Other

Bedroom 1

  • Location

  • Flooring/Subfloor

  • Wall Finish

  • Ceiling Finish

  • Windows (with # to be replaced)

  • Closet / Shelving

  • Receptacles / switches

  • Light fixtures

  • Doors

Bedroom 2

  • Location

  • Flooring/Subfloor

  • Wall Finish

  • Ceiling Finish

  • Windows (with # to be replaced)

  • Closet / Shelving

  • Receptacles / switches

  • Light fixtures

  • Doors

Bedroom 3

  • Location

  • Flooring/Subfloor

  • Wall Finish

  • Ceiling Finish

  • Windows (with # to be replaced)

  • Closet / Shelving

  • Receptacles

  • Light fixtures / switches

  • Doors

Bedroom 4

  • Location

  • Flooring/Subfloor

  • Wall Finish

  • Ceiling Finish

  • Windows (with # to be replaced)

  • Closet / Shelving

  • Receptacles

  • Light fixtures / switches

  • Doors

Interior - General

  • Stairs / Handrails

  • Ceiling Finish

  • Wall Finish

  • Flooring / Subfloor

  • Built-In Closets / Storage / Shelves

  • Evidence of Water / Moisture Infiltration

  • Other

Overall condition of Home

  • Overall condition of Home

  • Would the cost of repairs be estimated at 75% or more of a replacement cost?

  • Disability/Accessibility

  • To the best of your knowledge, do any of the occupants have a physical or cognitive disability? If yes, please describe and provide recommended accessibility improvements:

  • Comments

  • Inspector Name:

  • Inspector Phone #:

  • Inspection Date:

  • Chester Brucks

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