*Name (First and Last)    *First:    *Last:

Relation to Transaction Please Choose One Buyer Seller Buyer's Agent Seller's Agent Owner Lender Buyers Lawyer Sellers Lawyer Relocation Company Other

*Mailing Address:   *City:    *State:    *Zip:

* Email:

*Phone:                         Home     Work     Mobile

Second Phone:                         Home     Work     Mobile              
 

Access:  Method of Access Home Will Be Left Open Neighbor Will Open Home Has Realitor Keybox Buyers Agent Will Open Sellers Agent Will Open Buyer Will Open Seller Will Open

*Electricity: Choose One Power "ON" Power "OFF" Unknown                             
*Utilities                            *Water: Choose One Water "ON" Water "OFF" Unknown TYPE Public Private Well /w Pump Unknown                                                 
*Fuel: Choose One Gas "ON" Gas "OFF" Propane "ON" Propane "OFF" No Fuel Source Unknown TYPE Public Sewer Septic Unknown   

Style: Single Family Dwelling Single Family w/ Inlaw Apartment Condo Duplex Non-Conforming Duplex Tri-Plex Multi-Family Dwelling    Approximate Year Built:   
Square Footage:            Source:  Please Choose One County Records MLS Sheet Best Guess           Occupied: Yes    No

Number of Bedrooms:            *Number of Bathrooms: 

Space Below Grade:  Please Choose One Crawl Space - ADD $50 Slab Basement Combination                                                                              
Garage:  Please Choose One One Car Two Cars Three Cars+ Car Port No Garage    Attached    Detached

Single Family Dwelling with Crawl Space                    Size including unfinished areas Up to 900 sq. ft ..... $285 901 - 1100 sq. ft ..... $305 1101 - 1400 sq. ft ..... $325 1401 - 1800 sq. ft ..... $345 1801 - 2300 sq. ft ..... $375 2301 - 2700 sq. ft ..... $395 2701 - 3100 sq. ft ..... $425 3101 - 3600 sq. ft ..... $455 3601 - 4300 sq. ft ..... $485 4301 - 4900 sq. ft ..... $535 4901 - 5600 sq. ft ..... $585 5601 - 6100 sq. ft ..... $675 - $785 6101 - 7100 sq. ft ..... $775 - $875 7101 - 8100 sq. ft ..... $875 - $985 8101 - 9100 sq. ft ..... $975 - $1085 9101 - 10,100 sq. ft ..... $1075 - $1300

Click Here if you are unsure if the home is considered a Single Family Dwelling, Single Family Dwelling w/In-Law unit,
Duplex, Non-Conforming Duplex, or a Multiple Family Dwelling.

Duplex or Single Family Dwelling w/ In-Law Unit            Size including unfinished areas Up to 1400 sq. ft ..... $335 1401 - 1800 sq. ft ..... $355 1801 - 2300 sq. ft ..... $385 2301 - 3100 sq. ft ..... $405 3101 - 3600 sq. ft ..... $435 3601 - 4300 sq. ft ..... $485 4301 - 4900 sq. ft ..... $525 4901 - 5600 sq. ft ..... $575 5601 - 6100 sq. ft ..... $575 - $775 6101 - 7100 sq. ft ..... $675 - $875 7101 - 8100 sq. ft ..... $775 - $975 8101 - 9100 sq. ft ..... $875 - $1075 9101 - 10,000 sq. ft ..... $975 - $1275 10,001+ ..... Call

Radon Testing - Recommended
For more info see our "Radon" section ..... This is a 48 hour electronic measurement test.

Method of Payment          Credit Card          Check          Cash

PLEASE NOTE: Payment is expected either before the inspection by faxing your credit card information to our office at 585-288-8530, or on site at the conclusion of the inspection.

Note:  Upon clicking "Inspect My Home"  You will be redirected back to our home page.

M & M Home Inspections, Inc. "The Most Qualified Inspector In Town"

Marty Sample