Home Evaluation Data Collection Form
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1
2Residential Evaluation Data Collection Form
Home Evaluation Data Collection Form
Customer Name
Broker / Agent
Porter and McMillan Insurance
Address
901 Victoria Street
Prince George, BC V2L2K9
Postal Code
(250) 563-9217
Phone:
Producer
(250) 563-3492
Fax:
Date :
Evaluation Number :
Note :
Dwelling Information
Foundation Type
Property Access
Dwelling Style
Area
Sq. Ft.
Sq. M
Class
Dwelling Area
Slab
Standard Urban
Detached
Crawlspace
Zero Clearance
Semi-Detached
Unfinished Living Area
Basement
Hillside
Inside Row TH
Unfinished Basement
Walkout Basement
Rural Area
End Row TH
Finished Attic(s)
Economy
Avg
Luxury
Custom
Pier / Stilt
Island Access
Duplex
Finished Basement
Economy
Avg
Luxury
Custom
Hillside / Elevated
Remote Access
Triplex
Bonus Room
Economy
Avg
Luxury
Custom
Year Built
Year Total Renovation
Architecturally Designed
Yes
No
Interior Wall Height
% or Area
Exterior Wall Construction
% of Dwelling
Dwelling Type
Exterior Roofing
% of Roof
Concrete Block / Masonry
8" Ceilings/Interior Walls
1 Story
Asphalt, Roof Shingles
Stucco - Wood Frame
1 1/2 Story
9" Ceilings/Interior Walls
Tar and Gravel Deck
2 Story
Brick Veneer - Wood Frame
10" Ceilings/Interior Walls
Cedar Shingles, Shakes
2 1/2 Story
Concrete Fiberboard - Wood Frame
3 Story
Clay Tile/Slate
Wood/Vinyl Siding - Wood Frame
Vaulted Ceiling
Bi-level
Metal Shingle/Tile
Solid Brick/Masonry
Tri-Level
Cathedral Ceiling
Metal Panel Roof
Stone Veneer - Wood Frame
1 + Wings
1 1/2 + Wings
Solid Brick
Solid Brick
2 + Wings
Solid Stone
% or Area
Interior Flooring
Carpet, Nylon Plush
24oz
42oz
Exterior Door Type
Carpet, Wool, 32oz, patterned
Single Solid Wood/Metal
Vinyl
Tile 12"x12"
Sheet, Roll
Single Solid w/ 1 Sidelight Panel
Ceramic Tile
1"x1"
2"x2",2"x1"
Single Solid w/ 2 Sidelight Panels
Ceramic Tile
8"x8"
12"x12"
Double Solid Wood/Metal
Ceramic Tile
16"x16"
Double Solid w/ 1 Sidelight Panel
Hardwood
2 1/2"
3 1/4"
Double Solid w/ 2 Sidelight Panels
Hardwood
Parquet
Manufactured
Addition 1 Information
Addition 2 Information
Addition Stories
Exterior Wall Construction
% of Addition
Addition Stories
Exterior Wall Construction
% of Addition
Concrete Block / Masonry
Concrete Block / Masonry
1 Story
1 Story
1 1/2 Story
Stucco - Wood Frame
1 1/2 Story
Stucco - Wood Frame
2 Story
2 Story
Brick Veneer - Wood Frame
Brick Veneer - Wood Frame
Wood/Vinyl Siding - Wood Frame
Wood/Vinyl Siding - Wood Frame
Solid Brick/Masonry
Solid Brick/Masonry
Stone Veneer - Wood Frame
Stone Veneer - Wood Frame
Year Built
Year Built
Solid Brick
Solid Brick
Solid Stone
Solid Stone
Interior Wall Height
Area
Interior Wall Height
Area
Addition/Ell Area
Addition/Ell Area
8' Ceilings/Interior Walls
8' Ceilings/Interior Walls
9' Ceilings/Interior Walls
Finished Basement
9' Ceilings/Interior Walls
Finished Basement
10' Ceilings/Interior Walls
10' Ceilings/Interior Walls
Unfinished Basement
Unfinished Basement
Custom Features
Feature
Value
$
1.
$
2.
$
3.
$
4.
$
5.
$
6.
$
7.
$
8.
$
9.
$
10.
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