Builders Name *
Phone *
Address *
Email *
Point of Contact *
Lot Address
House Faces (select one) North South East West Northeast Northwest Southeast Southwest
Type
Waterproof R-value
Added Insulation Exterior
Added Insulation Interior
Other:
Basement
First Floor
Second Floor (if applicable) 7 8 9 10 11 12 13 14 15 16+
Third Floor (if applicable) 7 8 9 10 11 12 13 14 15 16+
Exterior Wall Insulation
Added Exterior Wall Insulation
Rim/Band Board R Value
Cantilever R Value
Floors Above Garage Insulation Value
Flat Ceiling Insulation Type
Flat Ceiling R Value
Sloped Ceiling Insulation Type
Sloped Ceiling R Value
Other:
Stud Size
Type of Insulation Used
Window Type
Window Material
Window Manufacturer
Model Number
U-Value of Window
SHGC of Window
Window Type
Manufacturer
Model Number
U-Value of Window
SHGC of Window
Type
Manufacturer
Model Number
U-Value of Door
SHGC of Door
Front Door / Side Door / Garage Door
Type
Manufacturer
Model Number
U-Value of Door
Number of Furnace Units
Fuel Type
Furnace Manufacturer
Model Number
Efficiency Percentage
BTUs
Furnace Second Unit Specs
Number of AC Units
Air Conditioning Type
AC Manufacturer
Model Number
SEER
TONs
AC Second Unit Specs
Number of Hot Water Units
Hot Water Tank Type
Tank Fuel Type
Hot Water Tank Manufacturer
Model Number
Recirculation System
Drain Hot Water Recovery System
Please Add Other Pertinent Information
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