Home Evaluation Request Your Name: Street Address: Owner's Name: City: Day Phone: District of City: Evening Phone: Province/State: Fax: ZIP/Postal Code: Email: Country: Please contact me via:EmailPostal MailPhoneFax Date Home Was Purchased: Square feet (above grade): Total # of Rooms: Type of Home Residential Attached Residential Detached Single Family Duplex Side By Side Duplex Up And Down Townhouse Lowrise Apartment Detached Condominium Highrise Apartment, Multi Level Highrise Apartment, Single Level Roof Type Asphalt Shingles Clay Tile Concrete Tiles Fiber Glass Metal Shingles Cedar Shakes Pine Shakes Tar & Gravel Vinyl Shingles Wood Shingles Style of Home Back Split Bi-Level Bungalow Hillside Bungalow Hillside Split Modular Home Recreational Use 2 Story Split 3 Level Split 4 Level Split 5 Level Split 1 And Half Storey 2 Storey 2 And Half Storey 3 Storey Apartment Penthouse Fireplace 0 1 2 3 4 5 Basement Type Crawl Space Dugout Full None Part Walkout Basement Development Fully Finished None Partly Finished Remodelled Basement Suite Unfinished Exterior Asbestos Asphalt Shingles Brick Cedar Composition Concrete Log Metal Wood Shingle Stone Stucco Vinyl Wood Parking No Garage On Street Off Street Parking Pad Cement Or Paved Underground Single Carport Single Garage Attached Single Garage Detached Double Carport Double Garage Attached Double Garage Detached Triple Garage Attached Triple Garage Detached Quad Or More Attached Quad Or More Detached Total Number of Bedrooms 1 2 3 4 5 6 7 More than 7 Location Type Busy Street Moderately Busy Street Quiet Street Corner Lot Cul-De-Sac Close to Park Adjacent to Park Total Number of Bathrooms 1 2 3 4 5 6 7 More than 7 Yard Landscaped Partially Landscaped Not Landscaped Age of Home New 1-5 Years 5-10 Years 10-15 Years 15-25 Years Makes no difference Notes: