Building Condition Assessment Survey
Building Name or ID
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessor Name
*
First Name
Last Name
Overall Building Condition
*
Excellent
Good
Fair
Poor
Critical
Structural Condition Rating
*
1
1
2
3
4
Best
5
1 is , 5 is Best
Roof Condition Rating
*
2
1
2
3
4
Best
5
1 is , 5 is Best
Electrical System Condition
*
Excellent
Good
Fair
Poor
Critical
Plumbing System Condition
*
Excellent
Good
Fair
Poor
Critical
Comments or Recommendations
Submit
Should be Empty: