Contact Name:   E-Mail :
Address:  City:
State:     Zip: 
Home Phone:  - -

Square footage of home:     Year home was built:
Style of home: Rambler   Split Entry   Two Story   Multi-level Mult-level walk out
Other, explain: 

Can you walk on the roof ? Yes No

Type of roofing material:  Asphalt  Wood  Tile  Slate
House was re-roofed years ago

Type of Siding:   Wood  Hardboard  Brick  Log  Vinyl  Stone
Other , explain: 
House was re-sided years ago

Brick Chimney Yes No    
- Number of flues:
- Number of dormers:
- Number of Roof vents:
- Number of roof turbines:
- Number of gable vents screens:
Condition of house:   Good  Ok  Poor

Description of the problem:


I agree that this is only an estimate only, the actual cost may be higher or lower. The house will still have to be inspected and at that time a complete cost will be determined.