First Name
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Last Name
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Phone
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Email
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Job Address
Street Address
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Street Address Line 2
City
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State / Province
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Postal / Zip Code
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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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Briefly Describe the Job
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Preferred Dates/ Time of Inspection and/or completion of works
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