Residential Quote Please provide us with as much information as possible so that we may provide you with the most accurate quote. Please fill in the blanks and we will contact you. Please Note: Any information you give us is confidential. You will not be placed on any mailing lists, phone lists, fax lists or email lists. Furthermore, we do not solicit our customers by mail, phone, fax or email. Company Name: Contact Name: Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming Zip Code: Office Phone: Extension: Home Phone: Cell Phone: Fax: Email Address: How would you prefer to be contacted? Office Phone Home Phone Cell Phone Fax Email When is the best time to reach you? Type New Remodel Units Single Family Duplex Condo Multi-Family Number of Units Total Square Footage Fuel Type Natural Gas Propane Gas/LP Oil No Gas/Other Gas Hook Ups Cooking Stove/Oven Water Heater Furnace/Boiler Clothes Dryer Fireplace Deck connection for grill Other None Heating Forced Hot Air Forced Hot Water Electric/Other Do you need a sprinkler system? Yes No Do you need engineered plans drawn up for the sprinkler system? Yes No Water Heater 40 Gallon 50 Gallon 75 Gallon Frost Proof Sillcocks Enter total amount needed: Water Supply Well City Sewer Septic City Water Piping Copper Pex Full Bathrooms How Many? Half Bathrooms How Many? Plumbing Fixtures All Kohler or Sterling by Kohler No Preference     Kitchen   Sink No Sink   Laminate counter tops/self rimming kitchen sink Single bowl stainless steel Double bowl stainless steel   Solid surface countert tops/Undermounted kitchen sink Single bowl stainless steel Double bowl stainless steel Garbage Disposal Please note: we do not install garbage disposals in homes with septic systems. Yes No Chrome Kitchen Faucet Single Lever with pull out spray Single lever with side spray Other Chrome Soap/Lotion Kitchen Dispenser Yes No Instant Hot Water Dispenser Yes No     Half Bathrooms   Sink Pedestal Sink Drop in Sink No Sink Chrome Faucet 4" Centered 8" Widespread Toilet Round Front Elongated     Full Bathroom   Sink One Two Type of Sink Drop in Sink Under Counter Sink No Sink Chrome Faucet One Two Type of Faucet 4" Centerset 8" Widespread Toilet Round Front Elongated Tub/Shower 5 Foot One Piece Unit Other Tub Shower Valve Chrome Valve Other     2nd Full Bathroom   Sink One Two Type of Sink Drop in Sink Under Counter Sink No Sink Chrome Faucet One Two Type of Faucet 4" Centerset 8" Widespread Toilet Round Front Elongated Tub/Shower 5 Foot One Piece Unit Other Tub Shower Valve Chrome Valve Other     Master Bathroom   Sink One Two Type of Sink Drop in Sink Under Counter Sink No Sink Chrome Faucet One Two Type of Faucet 4" Centerset 8" Widespread Toilet Round Front Elongated Tub/Shower Unit 4 Foot One Piece Unit 5 Foot One Piece Unit Other Tub Shower Valve & Trim Chrome Valve Other Whirlpool Yes No Type of Whirlpool 5x5 corner drop in 5x5 corner w/ apron front and tiling flange 6x3 drop in 6x3 corner w/ apron front and tiling flange One piece 6x3 whirlpool unit with shower walls and apron Whirlpool Tub Filter Valve & Trim Chrome trim and valve Other Additional Comments: Home Page | About Us | Contact Us | Builders | Home Buyers Retail & Showroom & Upgrade Options | Gallery | Directions © 2006, Powerhouse Corporation. All Rights Reserved.