New Customer Registration Form
Structural Inspection and Reports
Customer Details:
Full Name
*
First Name
Middle Name
Last Name
Customer Billing Address
*
Street Address
Street Address Line 2
City
State
Postal Code
Phone Number
*
Format: 0000-000-000.
email address
*
example@example.com
Site Inspection Address:
Street Address
Street Address Line 2
City
State
Postal Code
Type of Inspection required:
*
Distressed House Structural Inspection and Report
Pre-purchase Structural Inspection and Report
Pre-purchase Structural Assessment
Dilapidation Structural Inspection and Report
Feasibility Report (for undertaking renovations)
137B Owner Builders Report
Type of Inspection Required:
*
Please Select
Pre-Purchase Structural Site Inspection and Report
Distressed House Inspection and Report
Dilapidation Inspection and Report
Preferred Inspection Date:
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
How did you hear about us?
*
Please Select
Building Inspector
Real Estate Agent
Plumber
Underpinner
Word of Mouth
Other (please specify)
Name of Referee:
*
Name of Real Estate Agent (if applicable):
First Name
Last Name
Email: Real Estate Agent
example@example.com
Phone Number: Real Estate Agent
Please enter a valid phone number.
Format: 0000-000-000.
File Upload: Current Pest and Building Report (or other relevant info.)
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Notes: Any information deemed relevant by the Client for the Consulting Engineer:
1) 137B Reports: Description of Owner Builder Works Undertaken:
*
2a) 137B Reports: In preparation for the inspection, please provide the following relevant documentation (select if available):
*
Architectural drawings
Engineering drawings
Building Surveyor’s inspection report
Occupancy Certificate or Final Inspection Report
Building Permit
Soil Report
Other Certificates (e.g., plumber’s certificate, electrical certificate)
None of the above
2b) 137B Reports: Attach relevant documentation listed above - File Upload:
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3a) 137B Reports: Were any second-hand or re-used materials utilised in the build/renovation?
*
YES
NO
3b) 137B Reports: LIST ALL second-hand or re-used materials utilised and areas found:
*
4a) 137B Reports: Services Connected to the property (YES/NO):
*
Rows
YES
NO
Sewerage
Septic Tank
Water
Hot Water System
Gutters and Downpipes
Rainwater Tank
Surface Drains
Ducted Vacuum
Intercom
Gas
Electricity
Solar System (PV)
Air Conditioning
Heating
Fireplace
Smoke Alarm
Alarm
4b) 137B Reports: Services Connected to the property (other than above):
*
5a) 137B Reports: Have any internal walls been removed, or have any external walls openings been widened?
*
Yes
No
5b) 137B Reports: If YES was selected to Question 5a above, describe which walls were removed and which openings were widened:
*
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