2. Property Owner Name*
3. Phone Number*
5. Project Address*
7. HVAC Contractor*
9. HVAC License # *
10. HVAC License Expiration Date*
12. Contractor Phone Number*
13. Contractor Fax Number
15. Contractor Email Address*
17. Contractor Address*
19. Contractor E-mail*
21. New Single Family Dwelling
    -- Select One --$130 - Up to 1,500 SQ. FT$195 - 1,501 to 2,500 SQ. FT$260 - 2,501 to 3,500 SQ. FT$325 - 3,501 to 4,500 SQ. FTOver 4,500 SQ. FT $325 Plus $65 for each additional 1,000 SQ. FT or portion thereof

    Based on living space ONLY Single Family Dwelling, Include all buildings with HVAC being constructed on each Property.
22. Total Square Footage of Residential Building
24. Remodels/Other Residential Installation $65.00 (Type of Equipment)
    Includes but not limited to remodel/additions/retro-fits HVAC installations for Existing Residence, Modular, Manufactured or Mobile Homes, Detached Shops, Gas Pressure Test including Gas Appliance Installation, Solid Fuel and Fuel Oil Appliances, Hydronic Piping, Exhaust Fans, Room Addition Duct Extension and all other Requested Inspections.
25. NEW: Multi - Family Dwelling
    -- Select One --$260 - Duplex ApartmentThree or more multi family units: $130 per building plus $65 per unit ($130 X # of buildings) + ($65 X # of units)
27. Commercial/Industrial
    -- Select One --Up to $10,000: (Total cost of system X 0.02) + 60 = $Between $10,001 - $100,000: (Total cost of system - 10,000 X 0.01) + 260 = $Over $100,001: (Total cost of system - 100,000 X 0.005) + $1,160 = $

    All Commercial/Industrial require dated and signed total job cost valuation including all material and labor for accurate fee evaluation.
28. Total Valuation Cost of Commercial/Industrial Building
30. Total Amount Due *
31. What equipment is being installed?*
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