First Name: Last Name: Address (Project Location) Street: City: State: Zip/Postal Code:
Is this location a historical structure? Yes - No - Is this request covered by an insurance claim? Yes - No - Is this location a commercial location? Yes - No - Do you own the home for this request? Yes - No -
What is the appropriate status of this project?: Ready to hire - Planning and budgeting - When would you like this request to be completed? Timing is Flexible - 5-6 Weeks - 7-8 Weeks - 9-12 Weeks - More than 12 Weeks -
What type of remodeling project do you have? Kitchen - Bath - Other - What type of design preparation has been done? Sketches and/or basic idea of project - Professional drawings (complete set of plans) - Permits pulled - None -
*Daytime Phone: ext.: Evening Phone: Cell Phone (Recommended): *Email:
Best way to be contacted: Day Phone - Night Phone - Cell - Email -
Other Comments/Questions: Please put your comments and/or questions here, or the describe the job you are looking to have done in greater detail.
