PLEASE PRINT THIS FORM, THEN FILL OUT.     BACK TO PRECEDING PAGE.

This form must be completely filled out and signed.  Thank you.

Name:

Date:

Property Address:

Home Phone :

Work Phone:

Current Address if different:

Fax Number:

e-mail Address:

Has your property been appraised by Palo Verde Appraisals in the past?

Yes:           No: 

The following is required prior to the appraisal: 

·       Survey – As of May 3, 2000.

·       Floor Plan – As of May 3, 2000.

·       State of Condition as of May 3rd 2000 - See attached.

Comments:

Payment due at the time of inspection.

Cost:  $400.00 plus tax.

Note: Property owner will be the exclusive owner of the inspection.

BUILDERS/STRUCTURAL INFORMATION

Yes   No  N/A  D/K

1.What year was the home built? ____________________________

       

2, Is this a site-built home?

3. Type of construction: ___________________________________

       

4. Any earth movement, subsidence, or settlement problems?

       

5. Has major damage occurred to the property or any structure on the property?

       

6.   Any problems with interior walls, ceilings, doors, windows, floors, or attached floor coverings?

7.  Type of floor under carpets or linoleum:  ____________________

       

8.   History of wood infestation: insect or tree root problems? Specify date and type of last treatment:

       

9.   Any past or present problems with driveways; walkways; sidewalks or patios (such as large cracks; potholes or raised sections?) If so; what was done about it?

       

10. Any problems with retaining walls cracking or bulging?

       

11. Any significant cracks in foundations; exterior walls; interior walls; slab floors; ceilings; chimneys; fireplaces; decks or garage floors?

       

12. Any doors or windows that are inoperable or which may interfere with ingress or egress?

       

13. Any structural wood members below soil level?

Yes   No  N/A  D/K

       

14. Any past or present flowing or drainage problems on the property ? On adjacent properties ? Any standing water after rainfalls ? Any active springs ? Any water or moisture in crawlspace ? basement ? Garage ? Explain.

       

15. Landfill on any portion of the property?

For additional information or further explanation (indicate #)

PLUMBING

Yes   No  N/A  D/K

       

4.     Type of water pipes (copper; lead; pvc; galvanized; etc.) ___________________________________________________

       

2.   Any water pressure problems?

       

3.   Any plumbing system problems; leaks; freezing?

       

5.     Any bathroom ventilation problems?

       

6.     Approximate  age of hot water  heater:_______ Capacity: ______

Fuel source: _______

       

7.     Any domestic hot water problems?

       

8.     Type of sewage system (sewer; septic; cesspool; holding tank; etc.)_________________________________________________

      Public  Private . Planned and approved sewer system?

      Fees: _________________  Per __________________________

a. If private; name of service  company: ____________________

b. If private; date last pumped: ________ Size of tank : ________

          Location of tank: ___________  Date installed: ____________

          Permitted? _____________ Leach field? _________________

          Location:  _____________ Construction: ________________

For additional information or further explanation (indicate #)

ROOFS, GUTTERS AND DOWNSPOUTS

Yes   No  N/A  D/K

1.  Type  of roof: _______________________________________

         

2.  Age of roof: _________________________________________

       

3.   Is there present damage to the roof?

       

4. Has the roof ever been repaired? Date: ____________________

Nature of repairs: ______________  Repaired by: ___________

 

       

5.   Any problems with gutters or downspouts?          

For additional information or further explanation (indicate #)

ELECTRICAL

Yes   No  N/A  D/K

1. Is the electrical wiring copper  aluminum unknown ?

       

2. Is the house wired for 220 volt?

       

3. Any damaged or malfunctioning receptacles?

       

4. Any extension cords stapled to baseboards or underneath carpets or rugs?

       

5. Any defective, malfunctioning, or illegal installation of electrical equipment inside or outside the house?

For additional information or further explanation (indicate #)

HEATING AND COOLING

Yes   No  N/A  D/K

1.  Heating type: ________________ Approximate age: ___________

2.  Identify  unheated and/or uncooled rooms: ___________________

3.  Cooling type: ________________  Approximate age: __________

       

4.   Propane tank? Owned   Leased  From: ___________________

Yes   No  N/A  D/K

       

5.   Problems in heating/cooling systems?

       

6.     Is the furnace room/closet adequately vented?

       

7.   Are fuel-consuming heating devices adequately vented to the outside?

       

8.   Do fireplaces/woodstoves have operable dampers?

       

6.     Any problems with condition or functioning of duct work (such as mildew, restricted air flow, physical deterioration, odor, etc.)?

For additional information or further explanation (indicate #)

POOL, SAUNA OR HOT TUB

Yes   No  N/A  D/K

       

1.   Pool Sauna Built-in hot tub  Approximate age: __________

       

2.   Problems with pool, sauna or hot tub?

For additional information or further explanation (indicate #)

MISCELLANEOUS

Yes   No  N/A  D/K

       

1.   Provision for outside venting of clothes dryer?

       

       

2.   Lawn sprinkles  Drip irrigation  Automatic timer 

Any Problems?

       

       

3.   Electric garage door opener? Number of controls:  ____________

Any problems?

       

4.   Security system? Type: _________________________________

Owned Leased From: __________   Fee: ______  per: _____

       

       

5.   Smoke detectors? How many? _______ 11OV Battery

Any problem?

Yes   No  N/A  D/K

       

5.     Sump pump?

Yes   No  N/A  D/K

       

7.   Any problems  with sump pump?

       

8.   Kitchen range hook-up Electric Gas

       

9.   Clothes dryer hook-up; Electric Gas

       

10. Refrigerator water line?

       

11. Any problems with built-in appliances?

       

12. Have any pets resided in the home?

       

13. Any pet odors?

For additional information or further explanation (indicate #)

UTILITIES

Yes   No  N/A  D/K

       

1.   Natural gas:

In house

In street

To property line

       

2.   Electricity:

In house

In street

To property line

       

3.   Telephone:

In house

In street

To property line

       

4.   Cable TV:

In house

In street

To property line

       

5.   City water:

In house

In street

To property line

       

6.   Community water:

In house

In street

To property line

       

7.   City sewer:

In house

In street

To property line

       

8.   Community sewer:

In house

In street

To property line

       

9.   Any access to service problems?

For additional information or further explanation (indicate #)

CONDOMINIUMS-COMMON INTEREST DEVELOPMENTS

Yes   No  N/A  D/K

1.  Please check the availability of  copies of the following documents;

      Covenants, Conditions, and Restrictions or Declaration of Condominium ; Association Bylaws Articles of Incorporation of Association ; Current financial statement of Association ; regulations currently in force Minutes of Board Meetings

Yes   No  N/A  D/K

       

2.   Does the Condominium Declaration contain any resale restrictions?

       

3.   Does the homeowners association have a first right of refusal?

4.  Association Fees: $ _________________ per ________________

     What is included in the association fees? ___________________

       

5.   Any contemplated future dues increases of special assessments? If so, give details: ________________________________________

       

6.   Any pending or threatened litigation either by or against the homeowners association?

       

7.   Are all dues, assessments, and taxes current?

       

8.   Security: Intercom  Closed circuit TV  Guards  Electric gate  Other: _______________________________________________

       

9       Does each unit have its own designated parking space?

Yes   No  N/A  D/K

10.Property Management Company and Address:

            ______________________________

            ______________________________

            ______________________________

            ______________________________

For additional information or further explanation (indicate #)

ENVIRONMENTAL

Yes   No  N/A  D/K

       

1.   Any noticeable continuous or periodic odors (such as from waste, agriculture, industry, etc.)?

       

2.   Any excessive noises (such as airplanes, trains, trucks, freeways, etc.)?

       

3.   Any hazards or hazardous materials on the property (such as asbestos, dumps, pesticides, radon, underground fuel storage tanks or leaks)?

       

4.     Any hazards or hazardous materials in close proximity to the property (such as lead, asbestos, dumps, pesticides, radon, underground fuel storage tanks of leaks)

For additional information or further explanation (indicate #)

RENTAL INFORMATION

Yes   No  N/A  D/K

       

1.   Is the property rented or occupied by a tenant? If yes, lease expiration date: ________________________________________

       

2.   Does the tenant have the right to extend the rental agreement?

       

3.   Are security deposits or prepaid rents being held? By whom and how much?

____________________________________________________

For additional information or further explanation (indicate #)

   Print (property owner):_________________________________  Date:___________________

   Signature (property owner):______________________________ Date:___________________