Personal & Contact InformationClient Name:Mailing Address: Street Address City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Home Phone:Business Phone:Area Code:E-mail:* Fax:Please check appropriate answer:I am a: First time Home Builder I have built a home previously Tax Parcel Number: Street Address City State / Province / Region Building JurisdictionAny code or zoning variances, environmental, access or other challenges to build on this land?YesNoExplain the land challengesAre there any easement(s) on the property?YesNoExplain Easment(s):What are the setback restrictions?Side Yard:Front Yard:Back Yard: Please attach survey and topography map informationArchitectural style of project:CraftsmanTraditionalSpanishVictorianFrenchBungalowDutchColonialFarmhouseSouthwesternCoastalCarpenter GothicZenModernContemporyEuropeanTudorMediterraneanVacationFar EastGeorgianNeo-TraditionalGreek RevivalArchivalCheck the appropriate space: Rambler Daylight Basement Tri-Level Two-Story 1 1/2 Story 2 1/2 Story Full Basement Split Level Three-Story House Sqft Project Budget:Cost of the land: $Building Cost: $Site Development Costs $Allowance for Selections / Upgrades $Building Permits $Architectural / Civil / Structural Engineering $Total Project Budget Home Occupant ProfileList family members living at home, please include ages of children, etc.Type of entertaining? (business, seasonal, clubs, etc.)Family activities?Do You Own Pets(s)?YesNoIf yes, list animal type:List recreational vehicles: (boats, motorhome, etc.)Home Exterior SpecificationsPlease check all appropriate boxesDescribe Exterior Walls Brick / Stone Stucco Cedar Siding Vinyl Siding Wood Shakes / Shingles Board & Batton Smooth Smart Panel Hardi Cement Fiber-Board Other:Describe Roof Line Hip Modern Shed A-Frame Gable French-Hip Other:Describe Roofing Material Tile Cedar Composition Metal Other:Describe Entry Door Double Single Glazing Sidelights Transom Light Other:Describe House Windows Wood Frame Wood Vinyl Wood Metal Clad Metal Frame White Metal Frame Bronze Other:Manufacturer:Skylights - Specify Locations:Home Interior SpecificationsLiving Room FeaturesApprox. Room Size: Untitled Fireplace Cathedral Ceiling Bay Window Box Window Bow Window Miscellaneous (Book Case, Wet Bar, Piano Area, etc.)Dining Room FeaturesApprox. Room Size: Untitled French Doors Pass Through Ceiling Dome Butlery Miscellaneous (Built-In China Cabinet, etc.)Kitchen FeaturesApprox. Room Size: Untitled Center Island Built-In Double Oven Cook Top Grill Range Breakfast Bar Oven / Microwave Combo Lazy Susan Pantry Walk-In Pantry Kitchen / Office Sink(s) if more than one Trash Compactor Wine storage / Cellar Food / Waste Disposal Dishwasher Vaulted Ceiling Recessed Lighting Garden Window Appliance Garage Recycle Center Larger Refrigerator Miscellaneous (lighting, vaulted ceilings, gas / electric appliances, etc.)Family Room FeaturesApprox. Room Size: Entertainment Center Entertainment Center Game Storage Wet Bar Wine Sotrage / Cellar Bookshelves Woodstove Miscellaneous (big screen TV (built-in cabinets, cook top gril, etc.)Library / Den FeaturesApprox. Room Size: Untitled Hidden Safe Outside Entrance Desk Area Built-in Book Shelves Wet Bar Murphy Bed Computer Area Miscellaneous (Storage Closet, Etc.)Master Bedroom FeaturesLocation (First or Sectond Floor, etc.)Approx. Room Size: Sitting Room Sitting Room Book Shelves Dressing Area Window Seat Walk-in Closet His & Her Closet Wardrobe Closet Coffee Bar Mirrored Door Built-in Desk Built-in Safe Deck Miscellaneous (Bed Size - King, Queen, Double, Twin, Dressers, etc.)Master Bath Features Double Headed Shower Spa Tub Partially tiled shower / FG Flor pan Fully tiled shower His & Hers closets Closet Cabinetry Bidet Linen Closet Double Lavatory Vaulted Ceiling Skylights Private Sun Deck Extra ventilation Taller cabinets Heated Floors Heat Lamp Tub with Shower Combination 5 Piece Bath MiscellaneousSecondary Bedroom FeaturesNumber of Bedrooms:Location:Approx. Room Size: Untitled Dressing Area Walk-in Closet Private Bath Optional Den Jack & Jill Bath Optional Guest Room Optional Computer Room MiscellaneousSecondary Bathroom(s) FeaturesItems: Shower Linen Closet Spa Tub Double Lavs Pedestal Sink Tub Shower Combo Example: Powder Room off entry:Bathroom #1Bathroom #2Bathroom #3 MiscellaneousLaundry Room FeaturesLocation: Explain (First or Second Floor) Wash Basin Mud Room Off Garage Extra Countertop Space Washer Dryer Enclosed Cabinetry Open Shelving Built-In Ironing Board Extra Storage MiscellaneousGarage(s) One Car Two Car Three Car Attached Motor Court Detached rear of house Side Entry R.V. Workshop OtherFireplace(s) / Woodstoves(s) Mantel Raised Hearth Stone Faced Flush Hearth Pellet Natural Gas Wood Burning Propane Example: Living Room:Fireplace #1Fireplace #2 Heating and Cooling Heat Pump Forced Air Electric Forced Air Gas Electric Wall Mount Radiant Heat Air Conditioning Ductless Mini-Split Solar Geo-Thermal OtherRoom With A View PriorityList rooms 1 through 10, begin with the most important room.1.2.3.4.5.6.7.8.9.10. View Information (territorial, ocean, lake, mountain, etc.)Special Effects and Amenities Hot Tub Swimming Pool Art Gallery Media Room Closet w/built-in organizers Loft Mother-In-Law Suite Motor Court Sun Room Screen Porch Special Lighting Guest Suite Outdoor Decks / Patio Workshop Outdoor Kitchen Exercise Room Pet Room Rotunda Hobby Room Billiard Room Pool House Elevator Porte Cochere Solarium Grand Stair Foyer Computer Room Home Office Vault Room OtherCAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.
