Order Form Remember to use your mouse or the tab key to move from field to field. Rick Daniel Home Inspections 30000 Kasson Road #48 Tracy, CA 95304 rick@homeinspectorinc.com HOME INSPECTION REQUEST ORDER FORM PURPOSE OF THIS FORM This form provides a means to collect the data needed to schedule an inspection appointment, send out the "official" Inspection Agreement, prepare the report template and connect with the client to discuss how we can best serve their needs. Today's Date * Your Name Your Email Address BUYER'S INFORMATION Buyer's Name Buyer's FULL Mailing Address, CITY, STATE, ZIP Buyer's Phone Number Buyer's Email Address Buyer's Realtor/Agent Information Buyer's Realtor/Agent Name Agent's Company Agency FULL Mailing Address, CITY, STATE, ZIP Buyer's Agent Phone Number Buyer's Agent Email Address OWNER'S INFORMATION Owner's Name Owner's FULL Mailing Address, CITY, STATE, ZIP Owner's Phone Number Owner's Email Address Owner's Realtor/Agent Information Owner's Realtor/Agent Name Agent's Company Agency FULL Mailing Address, CITY, STATE, ZIP Owner's Agent Phone Number Owner's Agent Email Address INSPECTED PROPERTY DETAILS Inspected Property FULL Address including the City *REQUIRED FIELD* * Please do not assume I know what city your inspection is in. Year Built Square Footage The Premium Inspection fee is based on the square footage. See "Price List" for fee. Select Inspection Type Premium Inspection. Full Descriptive Detail. Cash Discount Available. Fees Based on Sq. Ft. Occupancy Status Occupied full time Vacant. No furniture Furnished, occupied part time Utilities Status. Check all that apply. Power is "ON" Power is "OFF" Water is "ON" Water is "OFF" Gas is "ON" Gas is "OFF" No Gas on the property Garage Status? Check all that apply. (Depending on size, an additional $55-$75 fee is added for each detached garage) None Attached Detached Attached and detached garages are both present. Attached Definition: You can walk directly from the inside of the living space into the garage. Detached Definition: You have to fully exit the living space to access the garage. Detached Building Status? (Depending on size, an additional $55-$75 fee is added for each detached "non-living space" building) None Detached Barn Detached Shop Other (please describe in "Special Instructions" below). Additional Living Spaces? (Multiple Dwellings, Multiple Tenants) Check all that apply. Additional "Custom" fees apply. None Multiple living quarters in the same building (ie: duplex, triplex, apartments) Multiple buildings with separate living quarters (ie. Mother-In-Law cottage, etc). BILLING AND ACCESS DETAILS Method of Payment To Be Determined by Inspector Paid Direct By Check Paid Direct By Cash ($50 discount off the base fee) Paid by Credit or Debit Card Paid Direct By "Zelle" To Be Paid Through Escrow (an additional signature document will be sent confirming this request) This order form is not an Inspection Agreement and does not hold the client's representative responsible for any financial obligation. The client is solely responsible for payment of this service. The actual Inspection Agreement will be sent after discussing the process with the client. TITLE COMPANY Title Company Escrow Officer Title Company FULL Address, CITY, STATE, ZIP Title Company Phone Number Escrow Officer's Email Address Escrow Number Escrow Closing Date How Will I Gain Access To The Property? Who Will Be Present? Include Special Instructions and Inspection Date Requests Here RESIDENTIAL INSPECTION AGREEMENT NOTICE Revision: April 29, 2024This form document NO LONGER represents an agreement to conduct work for the client. This form provides a means to collect the data needed to schedule an inspection appointment, send out the "official" Inspection Agreement, prepare the report template and connect with the client to discuss how we can best serve their needs. Click the button below to submit your order request, then call (209) 768-2142 to set an appointment. Thank you Δ