Residential Take-Off Form

Name
Address
City
State
Zip
Phone
Fax
Email address
Job location
Job name
Date Select date from pop-up calendar
StandardOptional
 Plug  Oven (220V)
 Single Pol Switch  Cooktop (220V)
 3-Way Switch  Dryer (220V)
 Inside Light  Well (220V)
 Outside Light  4-Way Switch
 Inside GFCI Plug  A/C Unit (220V)
 Outside GFCI Plug  Recessed Light
 Permit  Phone & Cable
 Service (Amp size)   Electric Tub
 Smoke Detector  Softener
 Exhaust Fan  Microwave - Installation
 Basement Light  Ceiling Fan - Installation
 Disposal, Dishwasher, Furnace, Laundry, Garages, Sump Pump  Fan/Light Combo
   Decorative Device
 Gas Range & Hood Wiring  Split Plug
 Chime & Thermostat Wiring  Electric Hot Water Tank
 GFCI & AFCI  Bedroom Light
 Hanging Light Fixture  Alarm Circuit
   Under/Over Counter Light
 Base price per sq. ft......Above items per each. Minimum to code.