Merritt Home Inspections

	Since 1993 A.I.I. Certified Home Inspector *Nat'l Home Inspector Examination (EBPHI)® Tested*	Rich O'Toole 530.277.4700 fax 530.268.7531 email The Inspector contact Scott for commerical inspections P.O. Box 1733 Grass Valley CA 95945

Client Information: * Represents Required Field
*First Name
*Last Name
Relation to Transaction
*Mailing Address
Email		Please send the report via email
*Phone		Home Work Mobile
Alternate Phone		Home Work Mobile
Agent Information:
Agent's Name
Real Estate Office
Agent's Email		Please send the report via email
Agent's Phone		Home Work Mobile
Agent's Alt Phone		Home Work Mobile
Merritt will provide the Client and their Agent a copy of the report. With client's permission, Merritt will send a copy of the report to the agent representing the other side of the transaction. Do you want that?		Yes No (You may add this later.)

Property Information: The Inspection Fee is based on the information you provide. Fill in what you know.
Inspection Address
Access Provided By
Are ALL Utilities "Up and Running?" (Gas/Propane, Water, Electric)		Yes No
Type of Dwelling
Approximate Year Built
Square Footage	Sq Ft	Source:
Occupied	Yes No
Number of Bedrooms
Number of bathrooms
Space Below Grade
Garage		Attached Detached
Outbuildings to be included in Inspection
Special Concerns and Comments

Scheduling Information:
Time preference: AM PM	Date preference:	We will make every effort to meet your scheduling needs.
Please note: Payment is due at the time of inspection. Accounts not paid at that time, including payments made at close of escrow, will be billed at a higher rate.