First Name *

Last Name *

Phone *

Email *

Street Address *

Street Address Line 2

City *

State / Province *

Postal / Zip Code *

Dwelling Type *

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Single Story
Double Story
Split Level
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Roof Type *

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Pitched
Flat
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Switchboard fitted with RCD protection (safety switches) *

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No

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Briefly Describe the Job *

Preferred Dates/ Time of Inspection and/or completion of works *

File Upload

Please upload all relevant photos of job - this will assist with quote turnaround