1. I/ we plan to build a custom home ___ for myself /ourselves or ___ speculatively.
2. I plan to build on a flat ___, sloping ___, or irregular ___, site. (check one)
3. ___ I do not have a site purchased. Please design a Dream Home for me per the specifications outlined herein.  ___ I have purchased a lot. (check one)                                                                                                                          [Please include site survey, setbacks, height restrictions, and all applicable code or jurisdictional information.]
4. I will be building in a deed-restricted community. (yes/ no) [If yes, supply complete architectural design standards and covenants.]
5. The site vegetation and topography can be described as follows: _____________________________________________________   _____________________________________________________         [Send topographical map and tree survey if site purchased.]
6. The surrounding area and immediate lots to left and right and across the street are described as follows: _____________________________________________________     _____________________________________________________              [Supply photographs as deemed necessary.]
7. The total area of conditioned space I wish to achieve is between ______ SF and ______ SF.
8. My approximate budget per square foot of conditioned space (measured to outside of bearing wall) is approximately $____/ SF, or maximum budget of $_________ for house construction alone.  NOTE: Architect cannot be held liable for cost of house exceeding Client budget. Client must check with Realtors or Builders in his or her area to arrive at projected costs per style of house, budget, and location.
9. The style of home I would like can best be described as: [Option: send any photos, drawings, plans, etc. on file or from scrapbook.] __________________     ______________________________________________________    ______________________________________________________    ______________________________________________________
10. I like/ do not like symmetry in my plans or elevations. (circle one and explain)       ___________________________________________________ ______________________________________________________
11. The total number of bedrooms is ____. The total number of baths is ____. I wish to have the following rooms (circle Y for yes or N for no), with approximate sizes indicated in length and width and a short description of each.:

           ___ Complex (highly irregular plan with many angles and/or curving walls inside and out, expensive to detail, finish out and construct)

    ADDITIONAL COMMENTS AND DESCRIPTIONS

___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    ___________________________________________________________    

Continue only to request a formal contract for review.  Proceed below to order your Schematic Floor plan and Preliminary Elevation per Fee Schedule.

PAYMENT CALCULATIONS (only if ordering plans now, not for quote):

Total size of home= ____ Estimated Total Buildable area or Square Feet (Air conditioned space, plus other area under roof -- garages, porches, balconies, wall thickness) 

Total size: ______SF (multiplied by cost of design per SF) X _____$/ SF= $ _______ Cost of Design FEE

If your Design Fee is over $10,000, a 30% retainer will be accepted to commence design for Schematic Floor Plan and Preliminary Elevation.  Balance due required upon submittal of Schematic Floor Plan in order to finish Preliminary Elevation.  Entire fee due to commence design on either Schematic Floor Plan only or Preliminary Elevation only.  Fees for Schematic Floor Plan and Preliminary Elevation as a package will be credited towards Permit Set option.  Please see Fee Schedule.

I am sending this form with payment using __ credit card (form below), __ mailed check

Make sure to fax this form to 305/ 425-5855 next to complete your order.

 Pay with Credit Card below:

                 FEE to be billed to credit card (or send check) = $ _______

Name on Credit Card: ________________________________________

Credit Card Company: ___________________

Credit Card No.: _______________________

Expiration Date: _______________________

Mailing Address:________________________  Name

                             _________________________ Street

                            _________________________ City, State and Zip Code

Credit Card billing Address:________________________  Name

                             _________________________ Street 

                            _________________________ City, State and Zip Code

PLEASE INCLUDE THE FOLLOWING IN ORDER TO VERIFY QUESTIONNAIRE INFORMATION.

I/We heard of your company and services  from __________________________________________________________

NOTE: PLEASE TRANSMIT AN E-MAIL MESSAGE CONFIRMING YOUR ORDER.                       Send e-mail indicating you have placed an order to: johnhenryarchitect@gmail.com .

Fax or mail all materials and remit payment by check or credit card, and address all future correspondence and payments to:

fax this form back to: 305/ 425-5855

To Contact architect via e-mail: johnhenryarchitect@gmail.com      To Contact architect by phone: 407/ 421-6647

Copyright 1999/ 2006/2009/2013 John Henry Design International, Inc.