Contractor |
____________________________ |
Address |
____________________________
____________________________ |
Phone |
____________________________ |
Fax |
____________________________ |
Project
Name |
____________________________ |
Address |
____________________________
____________________________ |
Proj.
Mgr. |
____________________________ |
Superintendent |
____________________________ |
| Job
Site Phone |
________________________________ |
Job
Site Fax |
________________________________ |
| |
|
| JOB
DESCRIPTION |
| ____
New Construction |
____ Renovation/Demo |
| ____
Year Built (if Renovation) |
Height
of Building |
____________________________ |
Height
of Top Chute |
____________________________ |
Number
of Floors |
____________________________ |
| Floor
Height |
| (1)
_____ |
(6)
_____ |
(11)
_____ |
| (2)
_____ |
(7)
_____ |
(12)
_____ |
| (3)
_____ |
(8)
_____ |
(13)
_____ |
| (4)
_____ |
(9)
_____ |
(14)
_____ |
| (5)
_____ |
(10)
_____ |
(15)
_____ |
|
| Floor
Thickness |
___________ |
Distance
of the
Interior Wall to the Outermost Point |
___________ |
Floor
Construction |
___________ |
Floors
w/ Intakes |
___________ |
Ceiling
Construction |
___________ |
Job
Phasing |
___________ |
Sill
Hgt from Floor |
___________ |
Perimeter
Beams |
___________ |
Total
Wall Thickness |
___________ |
Size |
___________ |
Exterior
Wall Const |
___________ |
Date |
___________ |
Window
Size |
W)
__________
H) __________ |
Rep |
___________ |
Hgt
from Ground
to 1st Intake |
___________ |
Quote |
___________ |
Architectural
Obstructions
(ie Cornice) |
___________ |
Installation
Date |
___________ |
Affected
Floors |
___________ |
Est.
Dismantle |
___________ |
|
| |
|
| CRANE |
|
Boom
Hgt |
____________________________ |
Tons |
____________________________ |
Permits
Required? |
Y
/ N |
Who
Supplies Crane |
____________________________ |
Accessibility
to Job |
____________________________ |
| |
|
| CONTAINERS/DUMPTRUCK |
Distance
from Building |
____________________________ |
Type
of Container/Size |
____________________________ |
Other |
____________________________ |
|
____________________________ |
Completed
by |
____________________________ |
| |
|
| FAX
COMPLETED FORM TO: 888-4-CHUTES (1-888-424-8837) |
