Puyallup Heating and Air Conditioning

General Information
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Please enter the general information requested below so your comfort specialist can quickly assess your needs.

1.	Which of these fuels do you use in your home?
	Electric
	Natural Gas
	Propane
	Fuel Oil
	Wood

3.	What year did you move into your home?

5.	What is your home's construction type?
	Wood Frame
	Steel Frame
	Other

6.	Including yourself, how many people live in your home?

7.	Select the statement that best completes this sentence:
	"Someone is home. . . "
	All of the time
	Most of the time
	Some of the time
	Not at all

8.	What is the heated/cooled square footage of your home?

9.	What year was your home built?

10.	How would you describe your home's foundation?
	Slab on grade
	Enclosed crawl space (no foundation vents)
	Open crawl space (has foundation vents)
	Full basement

11.	On average, at what temperature do you set your thermostat?
	Summer
	Winter

Insulation

12.	What is the level of insulation in your attic?
	Poor (0" - 3" of insulation)
	Ok (3" - 6" of insulation)
	Fair (6" - 9" of insulation)
	Good (9" of insulation)
	Excellent (10" of insulation or more)

Window & Doors

15.	On a windy day, which best describes the amount of air leakage around your windows?
	Very drafty
	Moderate air movement
	No draft

16.	What is the condition of your door's weather-stripping?
	Poor
	Average
	Good

17.	Which one of the following best describes the type of windows in your home?
	Single pane - without storm windows
	Single pane - with storm windows
	Double pane - without storm windows
	Double pane - with storm windows
	Triple pane - without storm windows
	Triple pane - with storm windows

18.	Which one of the following best describes the type of exterior doors in your home?
	Hollow wooden
	Solid wooden
	Insulated metal

Ducts & Sealing

20.	What is the condition of your air ducts?
	Poor
	Average
	Good
	Don't know

Cooling & Heating

21.	What is your main source of cooling?
	Central electric A/C	Evaporative Cooler
	Air Source heat pump	Central Gas A/C
	Dual Fuel heat pump	Electric Wall A/C
	Other	None

22.	What is your main source of heating?
	Gas furnace without pilot light	Gas furnace with pilot light
	Space heater (wall/floor)	Electric furnace (forced air)
	Other	None