Add Humana SSR

Cancel

Site Info

Site Info

  • Project Name

     

  • Related Site

  • Site Name

     

  • Record ID#

     

Site Contact Emails

  • Site Contact Email Sent?

  • Site Contact Email Received?

  • Site Contact Follow Up Email Sent?

  •      

Surveyor Submittal Status

  • Date Survey Due

     

  • Due from Surveyor?

  • ProntoForms Reference #

  • ProntoForms Data ID#

  • Date Submitted by Surveyor

  • Form Submitted by Surveyor?

  • Updated by ProntoForms

  • Fastfield Reference ID

General Site Contacts

General Site Contacts

  • Building Contact

  • **SSR Assignee.**

  •      

  • BC Name

  • BC Address

  • BC City

  • BC State

  • BC Zip

  • BC Phone #

    ext.

  • BC Website

  •      

  • Building Department Contact

  • BD Name

  • BD Address

  • BD City

  • BD State

  • BD Zip

  • BD Phone #

    ext.

  • BD Website

  •      

  • Zoning Contact

  • ZC Name

  • ZC Address

  • ZC City

  • ZC State

  • ZC Zip

  • ZC Phone #

    ext.

  • ZC Website

  •      

  • Electric Provider

  • **Surveyor.**

  • *EP Is there an exclusive provider required by the municipality or landlord for this location?

  • *EP Name

  •      

  • **SSR Assignee.**

  • EP Address

  • EP City

  • EP State

  • EP Zip

  • EP Phone #

    ext.

  • EP Website

  •      

  • Gas Provider

  • **Surveyor.**

  • *GP Is there an exclusive provider required by the municipality or landlord for this location?

  • *GP Name

  •      

  • **SSR Assignee.**

  • GP Address

  • GP City

  • GP State

  • GP Zip

  • GP Phone #

    ext.

  • GP Website

  •      

  • Water Provider

  • **SSR Assignee.**

  • WP Is there an exclusive provider required by the municipality or landlord for this location?

  • WP Name

  • WP Address

  • WP City

  • WP State

  • WP Zip

  • WP Phone #

    ext.

  • WP Website

  •      

  • Telephone Provider

  • **SSR Assignee.**

  • TP Is there an exclusive provider required by the municipality or landlord for this location?

  • TP Name

  • TP Address

  • TP City

  • TP State

  • TP Zip

  • TP Phone #

    ext.

  • TP Website

  •      

  • Data Provider

  • **SSR Assignee.**

  • DP Is there an exclusive provider required by the municipality or landlord for this location?

  • DP Name

  • DP Address

  • DP City

  • DP State

  • DP Zip

  • DP Phone #

    ext.

  • DP Website

  •      

  • Trash Provider

  • **SSR Assignee.**

  • TRP Is there an exclusive provider required by the municipality or landlord for this location?

  • TRP Name

  • TRP Address

  • TRP City

  • TRP State

  • TRP Zip

  • TRP Phone #

    ext.

  • TRP Website

  •      

  • Recycling Provider

  • **SSR Assignee.**

  • RP Is there an exclusive provider required by the municipality or landlord for this location?

  • RP Name

  • RP Address

  • RP City

  • RP State

  • RP Zip

  • RP Phone #

    ext.

  • RP Website

1.01 General Building Info.

1.01 General Building Info.

  •      

  • General Existing Conditions

  • **SSR Assignee.**

  • 1.01 Summary

  • **Surveyor.**

  • 1.01 Check if General Existing Conditions does not apply

1.01 General Existing Conditions

  • 1.01 *General Building Construction

  • 1.01 *Type of building

  • 1.01 *Front wall construction - Front Wall Thickness

  • 1.01 *Front wall construction - Front Wall Makeup

  • 1.01 *Rear wall construction - Rear Wall Thickness

  • 1.01 *Rear wall construction - Rear Wall Makeup

  • 1.01 *Demising Wall in Place?

  • 1.01 *Do interior walls go through ceiling grid?

  • 1.01 *Demising wall sealed to deck?

  • 1.01 *Demising wall construction - Demising wall thickness

  • 1.01 *Demising wall construction - Demising wall makeup

  •      

  • Indicate size of wall protrusions present that would impede new furniture installation.

  • 1.01 *Thermostat

  • 1.01 *Conduit

  • 1.01 *Heaters

  • 1.01 *Bump outs

  • 1.01 *Chair Rail

  • 1.01 *Plumbing

  • 1.01 *Columns

  • 1.01 *Not applicable

  •      

  • 1.01 *Are there stairs in the space?

  • 1.01 *Is there an elevator in the space?

  • 1.01 *Does the space have fire sprinklers?

  • 1.01 *Unusual Conditions/or odd demo items?

  • 1.01 *Are there signs of water intrusion around the windows and building envelope? If so, please speficy.

  • 1.01 *Are exam rooms/restroom doors 32” or more wide? Note any deficiencies.

  • 1.01 *Are all hallways and corridors at least 36” in width? Note any deficiencies.

  • 1.01 *Are there are any floor mats present?

  • 1.01 *Are interior plants present?

  • 1.01 *Are there any recycling and trash dumpsters/bins present both internally and externally?

  • 1.01 *Is there any evidence of any environmental hazards (mold, asbestos, etc.) based ONLY on observable conditions? If so, describe.

  •      

  • 1.01 Check if Exterior Structure table does not apply

Exterior Structure

  • Exterior Structure

  • 1.01 *Exterior Facade Condition

  • 1.01 *Exterior Gutters & Downspout Condition

  • 1.01 *Exterior windows and frames Condition

  • 1.01 *Foundation Condition

  • 1.01 *Wall Framing Condition

  • 1.01 *Misc. Framing & Envelope issues

  • 1.01 *Exterior wall finish at front of store

  • 1.01 *Exterior wall finish at rear of store

  • 1.01 *Exterior wall damage or issues?

  • 1.01 *Evidence of any leaks on exterior walls?

  • 1.01 *Damage Photo #1

  • 1.01 *Damage Photo #2

  • 1.01 *Damage Photo #3

  • 1.01 *Damage Photo #4

1.02 Doors

  • 1.02 *Check if Doors table does not apply

1.02 Doors

  •      

  • Doors

  • **SSR Assignee.**

  • 1.02 Summary

  • **Surveyor.**

  • 1.02 *Number of entries to the space

  • 1.02 *Wall finish at exterior of entry door(s)

  • 1.02 *Are there any electronic entry devices present?

  • 1.02 *Unusual Conditions/Items of Note

  •      

  • 1.02 Check if Door #1 table does not apply

Door #1

  • Door #1

  • 1.02 *Location

  • 1.02 *Door Type

  • 1.02 *Door Condition

  • 1.02 *Does the Door Open Freely?

  • 1.02 *Is the door weather tight?

  • 1.02 *Is the door damaged?

  • 1.02 *If damaged, Describe

  • 1.02 *Photos of damage provided?

1.02 Door Photos

  •      

  • 1.02 Top Half Door Photo

  • 1.02 Bottom Half Door Photo

  • 1.02 *Door #1 Context Damage Photo

  • 1.02 *Door #1 Close up Damage Photo

  •      

  • 1.02 Check if Door #2 table does not apply

Door #2

  • Door #2

  • 1.02 *Location 2

  • 1.02 *Door Type 2

  • 1.02 *Door Condition 2

  • 1.02 *Does the Door Open Freely? 2

  • 1.02 *Is the door weather tight? 2

  • 1.02 *Is the door damaged? 2

  • 1.02 *If damaged, Describe 2

  • 1.02 *Photos of damage provided? 2

1.02 Door Photos 2

  •      

  • 1.02 Top Half Door Photo 2

  • 1.02 Bottom Half Door Photo 2

  • 1.02 *Door #2 Context Damage Photo

  • 1.02 *Door #2 Close up Damage Photo

  •      

  • 1.02 Check if Door #3 table does not apply

Door #3

  • Door #3

  • 1.02 *Location 3

  • 1.02 *Door Type 3

  • 1.02 *Door Condition 3

  • 1.02 *Does the Door Open Freely 3?

  • 1.02 *Is the door weather tight? 3

  • 1.02 *Is the door damaged? 3

  • 1.02 *If damaged, Describe 3

  • 1.02 *Photos of damage provided? 3

1.02 Doors Photos 3

  • 1.02 Top Half Door Photo 3

  • 1.02 Bottom Half Door Photo 3

  • 1.02 *Door #3 Context Damage Photo

  • 1.02 *Door #3 Close up Damage Photo

  •      

  • 1.02 Check if Door #4 table does not apply

Door #4

  • Door #4

  • 1.02 *Location 4

  • 1.02 *Door Type 4

  • 1.02 *Door Condition 4

  • 1.02 *Does the Door Open Freely? 4

  • 1.02 *Is the door weather tight? 4

  • 1.02 *Is the door damaged? 4

  • 1.02 *If damaged, Describe 4

  • 1.02 *Photos of damage provided? 4

1.02 Doors Photos 4

  •      

  • 1.02 Top Half Door Photo 4

  • 1.02 Bottom Half Door Photo 4

  • 1.02 *Door #4 Context Damage Photo

  • 1.02 *Door #4 Close up Damage Photo

  •      

  • 1.02 Check if Door #5 table does not apply

Door #5

  • Door #5

  • 1.02 * Location 5

  • 1.02 *Door Type 5

  • 1.02 * Door Condition 5

  • 1.02 *Does the Door Open Freely? 5

  • 1.02 *Is the door weather tight? 5

  • 1.02 *Is the door damaged? 5

  • 1.02 *If damaged, Describe 5

  • 1.02 *Photos of damage provided? 5

1.02 Doors Photos 5

  •      

  • 1.02 Top Half Door Photo 5

  • 1.02 Bottom Half Door Photo 5

  • 1.02 *Door #5 Context Damage Photo

  • 1.02 *Door #5 Close up Damage Photo

  •      

  • 1.02 Check if Door #6 table does not apply

Door #6

  • Door #6

  • 1.02 * Location 6

  • 1.02 *Door Type 6

  • 1.02 * Door Condition 6

  • 1.02 *Does the Door Open Freely? 6

  • 1.02 *Is the door weather tight? 6

  • 1.02 *Is the door damaged? 6

  • 1.02 *If damaged, Describe 6

  • 1.02 *Photos of damage provided? 6

1.02 Doors Photos 6

  •      

  • 1.02 Top Half Door Photo 6

  • 1.02 Bottom Half Door Photo 6

  • 1.02 *Door #6 Context Damage Photo

  • 1.02 *Door #6 Close up Damage Photo

  •      

  • 1.02 Check if Door #7 table does not apply

Door #7

  • Door #7

  • 1.02 * Location 7

  • 1.02 *Door Type 7

  • 1.02 * Door Condition 7

  • 1.02 *Does the Door Open Freely? 7

  • 1.02 *Is the door weather tight? 7

  • 1.02 *Is the door damaged? 7

  • 1.02 *If damaged, Describe 7

  • 1.02 *Photos of damage provided? 7

1.02 Doors Photos 7

  •      

  • 1.02 Top Half Door Photo 7

  • 1.02 Bottom Half Door Photo 7

  • 1.02 *Door #7 Context Damage Photo

  • 1.02 *Door #7 Close up Damage Photo

  •      

  • 1.02 Check if Door #8 table does not apply

Door #8

  • Door #8

  • 1.02 * Location 8

  • 1.02 *Door Type 8

  • 1.02 * Door Condition 8

  • 1.02 *Does the Door Open Freely? 8

  • 1.02 *Is the door weather tight? 8

  • 1.02 *Is the door damaged? 8

  • 1.02 *If damaged, Describe 8

  • 1.02 *Photos of damage provided? 8

1.02 Doors Photos 8

  •      

  • 1.02 Top Half Door Photo 8

  • 1.02 Bottom Half Door Photo 8

  • 1.02 *Door #8 Context Damage Photo

  • 1.02 *Door #8 Close up Damage Photo

  •      

  • 1.02 Check if Door #9 table does not apply

Door #9

  • Door #9

  • 1.02 * Location 9

  • 1.02 *Door Type 9

  • 1.02 * Door Condition 9

  • 1.02 *Does the Door Open Freely? 9

  • 1.02 *Is the door weather tight? 9

  • 1.02 *Is the door damaged? 9

  • 1.02 *If damaged, Describe 9

  • 1.02 *Photos of damage provided? 9

1.02 Doors Photos 9

  •      

  • 1.02 Top Half Door Photo 9

  • 1.02 Bottom Half Door Photo 9

  • 1.02 *Door #9 Context Damage Photo

  • 1.02 *Door #9 Close up Damage Photo

  •      

  • 1.02 Check if Door #10 table does not apply

Door #10

  • Door #10

  • 1.02 * Location 10

  • 1.02 *Door Type 10

  • 1.02 * Door Condition 10

  • 1.02 *Does the Door Open Freely? 10

  • 1.02 *Is the door weather tight? 10

  • 1.02 *Is the door damaged? 10

  • 1.02 *If damaged, Describe 10

  • 1.02 *Photos of damage provided? 10

1.02 Doors Photos 10

  •      

  • 1.02 Top Half Door Photo 10

  • 1.02 Bottom Half Door Photo 10

  • 1.02 *Door #10 Context Damage Photo

  • 1.02 *Door #10 Close up Damage Photo

1.03 Flooring

  • 1.03 Check if Flooring table does not apply

1.03 Flooring

  •      

  • Flooring

  • **SSR Assignee.**

  • 1.03 Summary

  • **Surveyor.**

  • 1.03 *Type of flooring present

  • 1.03 *Any openings or access panels cut out in the floor?

  • 1.03 *Unusual Conditions/Items of Note

Photos

  • 1.03 Flooring Photo #1

  • 1.03 Flooring Photo #2

  • 1.03 Flooring Photo #3

  • 1.03 Flooring Photo #4

1.04 Ceilings

  • 1.04 Check if Ceilings table does not apply

1.04 Ceilings

  •      

  • Ceilings

  • **SSR Assignee.**

  • 1.04 Summary

  • **Surveyor.**

  • 1.04 *Type of Ceiling

  • Minimum Height to Deck

  • 1.04 *MH to Deck - Front

  • 1.04 *MH to Deck - Middle

  • 1.04 *MH to Deck - Rear

  • Minimum Height to Structure

  • 1.04 *MH to Structure - Front

  • 1.04 *MH to Structure - Middle

  • 1.04 *MH to Structure - Rear

  • 1.04 *Height from floor to lowest HVAC

  • 1.04 *Height from floor to any additional vertical obstructions

  • 1.04 *Sprinkler System in Place?

  • 1.04 *Heads Dropped?

  • 1.04 *Sprinkler heads height AFF:

  • 1.04 *Unusual Conditions/Items of Note

Photos

  • 1.04 Ceilings Photo #1

  • 1.04 Ceilings Photo #2

  • 1.04 Ceilings Photo #3

  • 1.04 Ceilings Photo #4

1.05 Restrooms & 1.06 Plumbing

  • 1.05 Check if Restrooms table does not apply

1.05 Restrooms

  •      

  • Restrooms

  • **SSR Assignee.**

  • 1.05 Summary

  • **Surveyor.**

  • 1.05 *Restroom Location

  • 1.05 *What is supplying the hot water?

  • 1.05 *Is the water heater visible? Note location.

  • 1.05 *Condition of the hot water system?

  • 1.05 *Is a replacement of the hot water system recommended?

  • 1.05 *Does the water heater appear to be approaching EUL (Effective Useful Life)?

  • 1.05 *Does the restroom need to be checked for ADA compliance?

  • 1.05 *IMPORTANT: Size of water line servicing the space

  • 1.05 *Unusual Conditions/Items of Notes:

1.05 Photos

  • Wall Photos

  • 1.05 Restrooms Wall Photo #1

  • 1.05 Restrooms Wall Photo #2

  • 1.05 Restrooms Wall Photo #3

  • 1.05 Restrooms Wall Photo #4

  •      
  • Floor Photos

  • 1.05 Restroom Floor Photo

  • 1.05 Restroom Floor Photo 2

  • 1.05 Restroom Floor Photo 3

  • 1.05 Restroom Floor Photo 4

  •      
  • Ceiling Photos

  • 1.05 Restroom Ceiling Photo

  • 1.05 Restroom Ceiling Photo 2

  • 1.05 Restroom Ceiling Photo 3

  • 1.05 Restroom Ceiling Photo 4

  •      
  • Fixture Photos

  • 1.05 Restroom Fixture Photo

  • 1.05 Restroom Fixture Photo 2

  • 1.05 Restroom Fixture Photo 3

  • 1.05 Restroom Fixture Photo 4

  •      
  • Damage Photos

  • 1.05 Restroom Damage Photo

  • 1.05 Restroom Damage Photo 2

  • 1.05 Restroom Damage Photo 3

  • 1.05 Restroom Damage Photo 4

1.06 Plumbing

  • 1.06 Check if Plumbing table does not apply

  •      

  • Plumbing

  • **SSR Assignee.**

  • 1.06 Summary

  • **Surveyor.**

  • 1.06 *Water supply line size to building:

  • 1.06 *Water supply line size to space:

  • 1.06 *Sewer line size/material to building:

  • 1.06 *Sewer line size/material to space:

  • 1.06 *Gas Supply line size to building

  • 1.06 *Gas Supply line size to Space

1.07 Plumbing Photos

  •      

  • 1.06 Water Meter Photo

  • 1.06 Water Supply Line to Space Photo

  • 1.06 Waste Line Photo

  • 1.06 Waste Line Photo 2

  • 1.06 Waste Line Photo 3

  • 1.06 Building Sewer Cleanout Photo

1.07 Electrical

  • 1.07 Check if Electrical table does not apply

1.07 Electrical

  •      

  • Electrical

  • **SSR Assignee.**

  • 1.07 Summary

  • **Surveyor.**

  • 1.07 *Are there electrical panels in the space?

  • 1.07 *Location of electrical panels?

  • 1.07 *Total building amps:

  • 1.07 *Total Amps to Space

  • 1.07 *Are there panels serving the space that are outside of the space?

  • 1.07 *Electrical Panels load capacity?

  • 1.07 *Current connected load of electrical panels? (Note: Observation only. Panels are not opened at time of survey to determine connected load.)

  • 1.07 *Is there a dedicated meter to the space?

  • 1.07 *Meter number:

  • 1.07 *Is there a transformer serving the space?

  • Type of transformer?

  •      

  • 1.07 Check if Electrical Panel #1 table does not apply

Panel #1

  • Panel #1

  • 1.07 *Location

  • 1.07 *Panel Name

  • 1.07 *Manufacturer

  • 1.07 *Voltage

  • 1.07 *Amps

  • 1.07 *Main Breaker?

  • 1.07 *Phase

  • 1.07 *Wire

  • Poles

  • 1.07 *Total Poles

  • 1.07 *Total Poles Used

  • Photos

  • 1.07 *Panel Photo

  • 1.07 *Schedule Photo

  • 1.07 *Context Photo

  • 1.07 *Label Photo

  •      

  • 1.07 Check if Electrical Panel #2 table does not apply

Panel #2

  • Panel #2

  • 1.07 * Location 2

  • 1.07 *Panel Name 2

  • 1.07 *Manufacturer 2

  • 1.07 *Voltage 2

  • 1.07 *Amps 2

  • 1.07 *Main Breaker? 2

  • 1.07 *Phase 2

  • 1.07 *Wire 2

  • Poles

  • 1.07 *Total Poles 2

  • 1.07 *Total Poles Used 2

  • Photos

  • 1.07 *Panel Photo 2

  • 1.07 *Schedule Photo 2

  • 1.07 *Context Photo 2

  • 1.07 *Label Photo 2

  •      

  • 1.07 Check if Electrical Panel #3 table does not apply

Panel #3

  • Panel #3

  • 1.07 * Location 3

  • 1.07 *Panel Name 3

  • 1.07 *Manufacturer 3

  • 1.07 *Voltage 3

  • 1.07 *Amps 3

  • 1.07 *Main Breaker? 3

  • 1.07 *Phase 3

  • 1.07 *Wire 3

  • Poles

  • 1.07 *Total Poles 3

  • 1.07 *Total Poles Used 3

  • Photos

  • 1.07 *Panel Photo 3

  • 1.07 *Schedule Photo 3

  • 1.07 *Context Photo 3

  • 1.07 *Label Photo 3

  •      

  • 1.07 Check if Electrical Panel #4 table does not apply

Panel #4

  • Panel #4

  • 1.07 * Location 4

  • 1.07 *Panel Name 4

  • 1.07 *Manufacturer 4

  • 1.07 *Voltage 4

  • 1.07 *Amps 4

  • 1.07 *Main Breaker? 4

  • 1.07 *Phase 4

  • 1.07 *Wire 4

  • Poles

  • 1.07 *Total Poles 4

  • 1.07 *Total Poles Used 4

  • Photos

  • 1.07 *Panel Photo 4

  • 1.07 *Schedule Photo 4

  • 1.07 *Context Photo 4

  • 1.07 *Label Photo 4

  •      

  • 1.07 Check if Electrical Panel #5 table does not apply

Panel #5

  • Panel #5

  • 1.07 * Location 5

  • 1.07 *Panel Name 5

  • 1.07 *Manufacturer 5

  • 1.07 *Voltage 5

  • 1.07 *Amps 5

  • 1.07 *Main Breaker? 5

  • 1.07 *Phase 5

  • 1.07 *Wire 5

  • Poles

  • 1.07 *Total Poles 5

  • 1.07 *Total Poles Used 5

  • Photos

  • 1.07 *Panel Photo 5

  • 1.07 *Schedule Photo 5

  • 1.07 *Context Photo 5

  • 1.07 *Label Photo 5

  •      

  • 1.07 Check if Electrical Panel #6 table does not apply

Panel #6

  • Panel #6

  • 1.07 * Location 6

  • 1.07 *Panel Name 6

  • 1.07 *Manufacturer 6

  • 1.07 *Voltage 6

  • 1.07 *Amps 6

  • 1.07 *Main Breaker? 6

  • 1.07 *Phase 6

  • 1.07 *Wire 6

  • Poles

  • 1.07 *Total Poles 6

  • 1.07 *Total Poles Used 6

  • Photos

  • 1.07 *Panel Photo 6

  • 1.07 *Schedule Photo 6

  • 1.07 *Context Photo 6

  • 1.07 *Label Photo 6

1.08 Roofing

1.08 Roofing

  •      

  • Roof

  • **SSR Assignee.**

  • 1.08 Summary

  • **Surveyor.**

  • 1.08 *Roofing Type

  • 1.08 *Estimated Roof Age

  • 1.08 *Overall Condition of Roof

  • 1.08 *Indication of any recent roof repairs?

  • 1.08 *Does there appear to be proper roof drainage? (Note any deficiencies.)

  • 1.08 Check if Counter Flashing table does not apply

Counter Flashing

  • Counter Flashing

  • 1.08 *Loose/displaced metal?

  • 1.08 *Punctures?

  • 1.08 Check if Coping / Cap Flashing table does not apply

Coping / Cap Flashing

  • Coping/Cap Flashing

  • 1.08 *Loose/displaced metal? 2

  • 1.08 *Punctures? 2

  • 1.08 *Cracked/broken coping?

  • 1.08 Check if Drains table does not apply

Drains

  • Drains

  • 1.08 *Clear of debris?

  • 1.08 *Flashing?

  • 1.08 Check if Roof Surface table does not apply

Roof Surface

  • Roof Surface

  • 1.08 *Discoloration/standing water?

  • 1.08 *Cracking/wrinkling/buckling?

  • 1.08 *Punctures? 3

  • 1.08 *Alligatoring/blistering?

  • 1.08 *Vandalism?

  • 1.08 *Mechanical Damage?

  • 1.08 *Exposed felt/deck?

  • 1.08 *Soft areas?

  • 1.08 *Vegetative Growth?

  • 1.08 *Bare spots?

  • 1.08 *Gravel stop?

  • 1.08 *Other

1.08 Photos

  • 1.08 Roofing Photo #1

  • 1.08 Roofing Photo #2

  • 1.08 Roofing Photo #3

  • 1.08 Roofing Photo #4

1.09 RTUs / HVAC

  • 1.09 Check if RTUs / HVAC table does not apply

1.09 RTUs / HVAC

  •      

  • RTUs / HVAC

  • **SSR Assignee.**

  • 1.09 Summary

  • **Surveyor.**

RTU/HVAC Units (Original)

  • 1.09 *Number of RTUs/HVAC units (Master)

    (Zero) 0

  • 1.09 *General condition of all units

  • 1.09 *Age range of RTUs/HVAC units:

  • 1.09 *Replacement recommended?

  • 1.09 Inside Units Make

  • 1.09 Inside Units Model Numbers Summary (Override)

  • 1.09 Inside Units Model Number(s) (Master)

    • 1.09 Inside Units Serial Numbers Summary (Override)

    • 1.09 Inside Units Serial Number(s) (Master)

      • 1.09 Location of Inside Units

      • 1.09 Outside Units Make

      • 1.09 Outside Units Model Numbers Summary (Override)

      • 1.09 Outside Units Model Number(s) (Master)

        • 1.09 Outside Units Serial Numbers Summary (Override)

        • 1.09 Outside Units Serial Number(s) (Master)

          • 1.09 Location of Outside Units

          • 1.09 Fuel Type

          • 1.09 Capacity

          • 1.09 Curb Size

          • 1.09 Supplies Heat

          RTU/HVAC Unit #1

          • 1.09 Inside or Outside Unit #1

          • 1.09 General Condition of Unit #1

          • 1.09 Year of Manufacture Unit #1

          • 1.09 Replacement Recommended #1

          • 1.09 Location of Unit #1

          • 1.09 Unit Make #1

          • 1.09 Unit Model #1

          • 1.09 Unit Serial # Unit #1

          • 1.09 Fuel Type #1

          • 1.09 Capacity #1

          • 1.09 Curb Size #1

          • 1.09 Supplies Heat #1

          1.09 Photos

          • 1.09 RTU Photo #1

          • 1.09 RTU Photo #2

          • 1.09 RTU Photo #3

          • 1.09 RTU Photo #4

          • 1.09 RTU Photo #5

          • 1.09 RTU Photo #6

          RTU/HVAC Unit #2

          • 1.09 Inside or Outside Unit #2

          • 1.09 General Condition of Unit #2

          • 1.09 Year of Manufacture Unit #2

          • 1.09 Replacement Recommended #2

          • 1.09 Location of Unit #2

          • 1.09 Unit Make #2

          • 1.09 Unit Model #2

          • 1.09 Unit Serial # Unit #2

          • 1.09 Fuel Type #2

          • 1.09 Capacity #2

          • 1.09 Curb Size #2

          • 1.09 Supplies Heat #2

          RTU/HVAC Unit #3

          • 1.09 Inside or Outside Unit #3

          • 1.09 General Condition of Unit #3

          • 1.09 Year of Manufacture Unit #3

          • 1.09 Replacement Recommended #3

          • 1.09 Location of Unit #3

          • 1.09 Unit Make #3

          • 1.09 Unit Model #3

          • 1.09 Unit Serial # Unit #3

          • 1.09 Fuel Type #3

          • 1.09 Capacity #3

          • 1.09 Curb Size #3

          • 1.09 Supplies Heat #3

          RTU/HVAC Unit #4

          • 1.09 Inside or Outside Unit #4

          • 1.09 General Condition of Unit #4

          • 1.09 Year of Manufacture Unit #4

          • 1.09 Replacement Recommended #4

          • 1.09 Location of Unit #4

          • 1.09 Unit Make #4

          • 1.09 Unit Model #4

          • 1.09 Unit Serial # Unit #4

          • 1.09 Fuel Type #4

          • 1.09 Capacity #4

          • 1.09 Curb Size #4

          • 1.09 Supplies Heat #4

          RTU/HVAC Unit #5

          • 1.09 Inside or Outside Unit #5

          • 1.09 General Condition of Unit #5

          • 1.09 Year of Manufacture Unit #5

          • 1.09 Replacement Recommended #5

          • 1.09 Location of Unit #5

          • 1.09 Unit Make #5

          • 1.09 Unit Model #5

          • 1.09 Unit Serial # Unit #5

          • 1.09 Fuel Type #5

          • 1.09 Capacity #5

          • 1.09 Curb Size #5

          • 1.09 Supplies Heat #5

          RTU/HVAC Unit #6

          • 1.09 Inside or Outside Unit #6

          • 1.09 General Condition of Unit #6

          • 1.09 Year of Manufacture Unit #6

          • 1.09 Replacement Recommended #6

          • 1.09 Location of Unit #6

          • 1.09 Unit Make #6

          • 1.09 Unit Model #6

          • 1.09 Unit Serial # Unit #6

          • 1.09 Fuel Type #6

          • 1.09 Capacity #6

          • 1.09 Curb Size #6

          • 1.09 Supplies Heat #6

          1.10 Existing Signs

          • 1.10 Check if Signage table does not apply

          1.10 Existing Signs

          •      

          • Signage - General Existing Conditions

          • **SSR Assignee.**

          • 1.10 Summary

          • **Surveyor.**

          • 1.10 *Which of the following types of signs are present within 150 ft of the proposed location?

          • 1.10 *Identify the type of signage existing at the proposed location.

          • 1.10 *Describe exterior walls.  Identify obstructions and/or unusual signage attachment details to be addressed.

          • 1.10 *Describe the interior of the storefront. Identify obstructions and/or unusual signage attachment details to be addressed.

          • 1.10 *Describe material and color of storefront

          • 1.10 *Describe material and color of any existing sign band.

          • 1.10 *Condition of building signs

          • 1.10 *Condition of free standing sign

          • 1.10 *Notes

          • Photos

          • 1.10 *Photos of existing signs #1

          • 1.10 *Photos of existing signs #2

          • 1.10 *Photos of existing signs #3

          • 1.10 *Photos of existing signs #4

          1.11 Parking

          • 1.11 Check if Parking table does not apply

          1.11 Parking

          •      

          • Parking

          • **SSR Assignee.**

          • 1.11 Summary

          • 1.11 What is the formula for required accessible parking?

          • 1.11 What is the parking formula for medical use?

          • **Surveyor.**

          • 1.11 *Is there existing parking?

          • 1.11 *What is the condition of the existing parking?

          • 1.11 *What is the parking lot material (asphalt or concrete)?

          • 1.11 *Is a reseal/restripe needed in the parking lot?

          • 1.11 *Is there any damage to the curbing throughout the parking lot or entryway to the site?

          • 1.11 *Are there any deficiencies to the path of travel to the site? Note any damage to sidewalk.

          • 1.11 *Customer parking types

          • 1.11 *Are there any parking requirements?

          • 1.11 *Are parking lights recommended?

          • 1.11 *Based on existing conditions, will a variance be required?

          • 1.11 *Are there other tenants at this location requiring a high number of parking spaces?

          • 1.11 *Number of parking spaces (total)

          • 1.11 *Are accessible spaces provided?

          • 1.11 *How many accessible spaces are provided?

          • 1.11 *How many accessible parking signs are present?

          • 1.11 *Is there a van accessible space?

          • 1.11 *Is there an accessible aisle?

          • 1.11 *Are there accessible parking signs?

          • 1.11 *Is there a ramp at accessible path of travel?

          • 1.11 *How many ramps are within 25 feet of main entry?

          • 1.11 *Estimated distance from accessible spaces to front door.

          • 1.11 *Does there appear to be adequate vehicular access and egress to the parking for the proposed location?

          • 1.11 *Is there any evidence of inadequate draining throughout the parking lot? (If so, please specify.)

          • 1.11 Check if Parking Site Plan table does not apply

          1.11 Photos

          • 1.11 Parking Photo #1

          • 1.11 Parking Photo #2

          • 1.11 Parking Photo #3

          • 1.11 Parking Photo #4

          • 1.11 Parking site plan

          2.1 Building Codes

          • 2.1 Check if Applicable Codes table does not apply

          2.1 Building Codes

          •      

          • Applicable Codes

          • **SSR Assignee.**

          • 2.0 Summary

          • What are the applicable Building Codes?

          • 2.1 Building code

          • 2.1 Mechanical code

          • 2.1 Electrical code

          • 2.1 Plumbing code

          • 2.1 Fire code

          • 2.1 What are the applicable Municipal Codes?

          2.2 Permits

          2.2 Permits

          •      

          • Permits

          • **SSR Assignee.**

          • 2.2 Summary

          • 2.2 Check if General Requirements table does not apply

          2.2 General Requirements

          • General Requirements

          • 2.2 How many Construction Document sets are required at the time of submission?

          • 2.2 How may submittals be delivered to the jurisdiction?

          • 2.2 Is an appointment needed for submittal? If so, what is the current wait time?

          • 2.2 Check if Demolition Permit table does not apply

          Demolition

          • Demolition Permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          • 2.2 Check if Building Permit table does not apply

          Building Permit

          • Building Permit

          • 2.2 Requirements for application

          • 2.2 How long is the review?

          • 2.2 What are the fees?

          • 2.2 Check if Mechanical Permit table does not apply

          Mechanical Permit

          • Mechanical Permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          • 2.2 Check if Electrical Permit table does not apply

          Electrical Permit

          • Electrical permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          • 2.2 Check if Plumbing Permit table does not apply

          Plumbing Permit

          • Plumbing Permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          • 2.2 Check if Fire Permit table does not apply

          Fire Permit

          • Fire Permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          • 2.2 Check if Signage Permit table does not apply

          Signage Permit

          • Signage Permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          • 2.2 Check if Resubmittal table does not apply

          Resubmittal

          • Resubmittal

          • 2.2 Process for resubmittal

          • 2.2 Check if Other Permit table does not apply

          Other Permits

          • Other Permit

          • 2.2 Requirements for application

          • 2.2 If this is a separate submission, how long is the review?

          • 2.2 If this is a separate submission, what are the fees?

          2.3 Signage

          • 2.3 Check if Signage Permit table does not apply

          2.3 Signage

          •      

          • Signage Rules & Regulations

          • **SSR Assignee.**

          • 2.3 Summary

          • 2.3 What are the external signage restrictions?

          • 2.3 What is the maximum number of external signs allowed by type?

          • 2.3 What is the total area of signage allowed?

          • 2.3 Is there a height of sign restriction in place and what are the location parameters (height, projection, clearance AFG, etc.)?

          • 2.3 What is considered illuminated signage?

          • 2.3 Other

          • 2.3 Check if Interior Window Signage Permit table does not apply

          Interior Window Signage

          • Interior Window Signage

          • 2.3 Are there existing internal signs in the proposed space?

          • 2.3 What are the internal signage restrictions?

          • 2.3 What is the maximum number of signs allowed that can be seen from the street?

          • 2.3 May signs seen from the street be illuminated?

          • 2.3 Check if Awnings Permit table does not apply

          Awnings

          • Awnings

          • 2.3 Are there existing awnings at the proposed location?

          • 2.3 Are window / door awnings allowed?

          • 2.3 What is the maximum number of awnings allowed?

          • 2.3 Are Logos and Lettering allowed on the awnings?

          • 2.3 Will awnings (without graphics) require a sign permit or Landlord approval?

          • 2.3 What is the maximum area of awnings allowed?

          • 2.3 What is the minimum awning clearance AFG?

          • 2.3 What is the maximum awning projection from building allowed?

          3.0 Zoning Info & Site Conditions

          • 3.1 Check if Zoning table does not apply

          3.0 Zoning Info & Site Conditions

          •      

          • **SSR Assignee.**

          • 3.0 Summary

          • General Zoning Information

          • General Zoning

          • 3.1 Zoning Classification

          • 3.1 Property Zone & Map District ID

          • 3.1 Check if Use Classification table does not apply

          Classification

          • Use Classification

          • 3.1 Is medical use allowed?

          • 3.1 Is a variance required?

          • 3.1 Are public hearings required for a variance?

          • 3.1 Check if Evaluation table does not apply

          Evaluation

          • Evaluation

          • 3.1 Climate Zone

          • 3.1 Are there existing Covenants?

          • 3.1 Are there Restrictions?

          • 3.1 Are hurricane shutters required?

          4.0 Facility / Job Site Management

          • 4.1 Check if Construction Information table does not apply

          4.0 Facility / Job Site Management

          •      

          • **SSR Assignee.**

          • 4.0 Summary

          • 4.1 Construction

          • Construction Information

          • 4.1 What are the permitted hours to work on premises?

          • 4.1 What are the delivery procedures during construction?

          • 4.1 What is the dumpster removal procedure during construction?

          • 4.1 What are the portable toilet restrictions and placement options?

          • 4.1 What potential weather-related issues may affect construction and how?

          • 4.1 is there any current or planned remodel of the center that would affect construction?

          Printouts

          •      

          • **DO NOT click the Generate Buttons below until all information has been entered in QuickBase.**

          • Date SSR Completed

          • SSR Word Doc

          • Document Date

          Cancel
          FSU Projects
          Search
          TABLES REPORTS