Sealed Unsealed

Attic-Metal Attic-Tiled Flat Framed Metal

Light Medium Dark

Cavity Brick Brick Veneer Weatherboard Other

Slab on Ground Timber on Stumps Suspended Slab

Timber Suspended Slab

Tiled Carpet Floating Timber Other

None R2.5 R3.0 R3.5 Other

Yes No

None R1.5 R2.0 R2.5 Foil Only Other

Yes No

Timber/PVC Aluminium Aluminium Improved Aluminium Improved Thermal Break Other

Single Glaze Single Glaze - Low E Double Glaze Double Glaze - Low E Other

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes

Name

Phone

Email

House Location

House design details (if not shown on plans)

Floor to ceiling height , (meters)

Number of vented down lights:

If other , type of  wall

Flooring

Ground floor

Upper floor

Insulation

Is reflective foil sarking used under the roof?

Is there insulation in the walls?

Windows

Is draught proofing fitted to External Doors?

Any unflued gas heaters?

Any chimneys?

Are general construction gaps and cracks sealed?

Declaration

Address

Mobile

Number of exhaust fans:

Wall type

Roofing

Ceiling insulation (what level of insulation is added?)

Color

Is there insulation under the floor?

* Required

*

*

Address
(include postcode)

Type

Floor coverings

Select one

Select one

Select one

Select one

Select one

Select one

If other , type of covering  & location

Select one

If Other , specify R Value

If yes what insulation type and R value

Type of glass used?

Are there any skylights?

What are the window frames made of?

Do any of the windows have external shading devices?

Select one

Select one

Select one

Select one

Select one

Select one

Select one

If yes , shading details

Select one

If yes , skylight details & location

Select one

Is draught proofing fitted to Internal doors/toilets/bathrooms?

Select one

Draft Proofing

Select one

If yes , details of where located

Select one

If yes , details of where located

Any wall ceiling vents?

Select one

If yes , details of where located

Select one

Are there any Ceiling fans?

Select one

If yes , details of where located

Specify which areas of the house are heated/cooled?

Help deter "Junk" email , type letters/numbers above (case sensitive) in the adjacent box , then Submit

I agree to the declaration

All information in this application is true and correct. I understand that should any of the details in this application form or the related plans and specifications be changed or are omitted , then any star rating awarded to the design will become null and void. If the plans are changed after a rating has been given , the rating would have to be reassessed..

Provide any other details (not on the plans or specifications that you might think will affect the thermal Performance of the house

(Please Select Yes then enter verification)

*

* Required

If Other what type and R value

If Other what  frame type?

If Other what glass type?

Step 1:

Enter the comprehensive house details (if known) below. Note , at Step 2. (after form submission) , you will need to email me required plans/drawings

House Energy Rating - Building Thermal Assessment - Mandatory Disclosure (2 step process)

Energy

Web Design