Amwins Building Addon
Building Addon
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Heating and Electrical
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Building Information
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Verify Type of Contents
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Explain Other Contents (Leave Blank if None)
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Historical Building
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Yes
No
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National or Regional
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-- Please Select--
National
Regional
Both
Unable to determine
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Building Square Footage square feet
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Year Built
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Heat Updated in
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Wiring Updated in
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Plumbing Updated in
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Construction Type
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-- Please Select--
Frame
Joisted Masonry
Non-Combustible
Masonry Non-Combustible
Modified Fire Resistive
Fire Resistive
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Foundation
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-- Please Select--
Concrete Slab
Pier and Beam
Crawl Space Open
Crawl Space Closed
Elevated Pier
No foundation
Basement
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Roof Shape
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-- Please Select--
Open gable
Box gable
Hip
Mansard
Flat
Dormer
Hexagon
Gambrel
Other
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Name of Other Roof Shape
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Roof Type
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-- Please Select--
Composition Asphalt Shingle
Built-up
Metal
Rubber Membrane
Steel
Tile
Wood Shake
Other
Not confirmed
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Name of Other Roof Type
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Roof Age
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Roof Support
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Verification of Roof Support By
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Fire Separation
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Yes
None observed
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Trash or Dumpster Area
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Yes
No
None observed
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Exposure(s) on North
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Other Exposures on North (Leave Blank if None)
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Exposure(s) on South
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Other Exposures on South (Leave Blank if None)
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Exposure(s) on East
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Other Exposures on East (Leave Blank if None)
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Exposure(s) on West
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Other Exposures on West (Leave Blank if None)
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Address
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Building Identifier
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Heating/Cooling Type
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-- Please Select--
Central
Window units
Space heater
Suspended wall furnace
None
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Fuel Type
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Electric
Gas
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HVAC Storage Protection in Place
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Yes
No
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Wiring Type
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Copper
Aluminum
Knob and tube
Not confirmed
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Fuse Box or Circuit Breakers
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-- Please Select--
Circuit breakers
Fuses
Circuit breakers and fuses
None
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Name of Electrical Panels Installed
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Federal Pacific/Stab-Lok
Zinsco/Kearney
GTE-Sylvania
Challenger
Magnetrip
General Electric
Square D
Cutler Hammer
Siemens
Eaton
Schneider
Westinghouse
Other brand
Label not visible
Electrical panel not accessible
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Name of Other Brand of Electrical Panel
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Plan to Replace Panels Confirmed
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Yes
No
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Mounted Space Heaters
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Yes
No
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Missing Covers on Electrical Equipment
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Yes
No
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Temporary Wiring in Electrical Room
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Yes
No
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Combustible Material in Electrical Room
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Yes
No
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