4/25/2016
(800) 8914222 Ext.
THE AUTO CLUB GROUP
THE AUTO CLUB GROUP
ASI PREFERRED
2027.06
Agency Info:
Client Name:
Account #:
16-102-000587
FLP251922
Tracking #:
Policy #:
LARGO, FL 33770
1576 ROSERY RD NE
PAULA SANTIAGOInsured:
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Agency Memo / AlertEBucket =
Description =
Form Question # Form Value Client Value Reason
UnderScore Policy Summary
BucketForm_52190 56 TRUE TRUE Tree Limbs >= 3 inches in diameter overhanging E
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT
REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT
ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REOIRT BY YOU OR OTHERS. YOU AND ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
(C) Copyright 2007 - National Risk Services, Inc.
Po
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form
ati
on PAULA SANTIAGOInsured:
Agency:
Agency Phone:
Client:
Tracking Number:
Policy Number:
LARGO, FL 33770
1576 ROSERY RD NE
THE AUTO CLUB GROUP
(800) 8914222 Ext.
ASI PREFERRED
16-102-000587
FLP251922
38. There is an enclosed in-ground pool on the rear side.
56. Tree limbs greater than 3" overhang on the left side.
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT
REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT
ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REOIRT BY YOU OR OTHERS. YOU AND ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
Page 1 of 1
16-102-000587Dwelling Observation Survey (52190)2027.06
Insured: PAULA SANTIAGOLocation: 1576 ROSERY RD NE
City: LARGO State: FL Zip: 33770 Telephone: Coverage Amount: 190000.0000
Policy #: FLP251922Company: ASI PREFERRED
Agent: THE AUTO CLUB GROUPAgent Phone: (800) 8914222
Year Built: 1964 Sq Footage: 1303
Acct: Date: 0 4 / 2 1 / 2 0 1 6
DWELLING DESCRIPTION 01. Interview obtained. If so, whom?: Paula Santiago 02. Unable to confirm address 03. Type of dwelling: More than 4 family 4 family 3 family 2 family 1 family 04. Occupancy: Owner occupied Tenant occupied Vacant Seasonal Not interviewed 05. Commercial construction converted to residential Evidence of student housing Converted from single-family to multi-family 06. Non-traditional construction: A-frame construction Geodesic dome Earthen home Straw / Hay HUD tagged home Log home 06A. If log home: Log siding 1/2 log Full log 06B. If full log: Milled / Manufactured Handcrafted 07. Number of stories: (Check all that apply.) Other: 1 1.5 2 2.5 3 Bi-level Tri-level
1 9 6 4 08. Year built: Estimated Per interview 09. Foundation: (Check all that apply.) Basement Slab Crawl Space Pier & Post
Description of other: 10. Construction: Frame: % Masonry veneer: % Masonry: 1 0 0 % Other: % 10A. If frame, is any cement fiber exterior cladding present? Yes No Unknown
Other 11. Roof covering: (Check all that apply.) Composition Wood Tile Rubber Tar & gravel Other: 12. Roof type: (Check all that apply.) Gable Hip Gambrel Mansard Flat
13. Estimated roof life remaining: Less than 5 years 5 to 10 years More than 10 years 14. Current HVAC system: (Check all that apply.) Central Heat & Air Evaporative cooler Window units DWELLING CONCERNS
Paint chipping / peeling 15.Exterior wall / siding concerns 16.Foundation concerns 17.Open foundation 18.
19. Elevated surface concern: (Porches, decks, balconies, etc. Check all that apply.) Broken railing(s) In need of repair 19A. If missing railing(s), inches above ground: (Check all that apply.) 12" - 24" 25" - 35" 36" - 72" > 72" 20. Step problem(s): Steps in need of repair Broken handrail(s) Missing handrail(s): (Check all that apply.) 3 steps 4 steps 5 or more steps 21. Suspicion of synthetic stucco (EIFS) 22. Suspicion of asbestos siding 23. Gutter concerns 24. Renovations underway 25. Broken window(s) 26. Boarded window(s) 27. Roof in need of repair 28. Evidence of ice dams 29. Solid fuel device 30. Evaporative cooler on the roof 31. Wood shake siding
PREMISE CONCERNS 32. Evidence of dog(s) (not observed): (Check all that apply.) "Beware of Dog" sign noted Heard barking from inside house Dog house on premises 33. Dog(s) observed: Dog 1: Aggressive or vicious Bite history Predominant breed:
Dog 2: Aggressive or vicious Bite history Predominant breed:Dog 3: Aggressive or vicious Bite history Predominant breed:
34. Metal security bars on window(s) No quick releases evident 35. Outbuilding(s) on premises: (Check all that apply.) Need(s) paint Need(s) repair 400 - 599 sq ft 600 - 799 sq ft 800 sq ft or larger 36. Business on premises Type: Inventory maintained Employees Customer traffic 37. Heating oil tank(s) Underground 38. SlideSwimming pool(s): (Check all that apply.) Unfenced Non-latching gate In-ground Diving board 39. Un-nettedTrampoline(s): (Check all that apply.) Unfenced 40. Unfenced UncoveredHot tub or spa: (Check all that apply.) 41. Retaining wall In need of repair A. Check all that apply. Height: < 4' 4-6' > 6' Length: < 10' 10-20' > 20' B. Est. length (ft): 42. Height above water: (In feet.) Lake/pond within 1,000 feet Distance from water: (In feet.) 43. River/canal within 1 mile Distance from water: (In feet.) Height above water: (In feet.) 44. Ocean/tidewater within 1/2 mile Distance from water: (In feet.) Height above water: (In feet.) 45. Subject to flooding
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
46. Subject to landslide 47. Hillside / Slope: Degree of slope: 48. Distance:Brush or forest within 300 feet: 0 - 50 ft 51 - 100 ft 101 - 300 ft 49. Farming or ranching 50. Farm animal(s)/livestock 51. Exotic animal(s) 52. Above-ground gasoline
or diesel tank(s) 53. Above-ground LP tank(s)
54. Sidewalk(s) in need of repairSurface elevation change:
< 1" 1" - 3" > 3" 55. Driveway(s) in need of repair
Surface elevation change: < 1" 1" - 3" > 3"
56. Tree limb(s) overhanging roof Limbs diameter < 3" Limbs diameter 3" or more
57. Tree limb(s) touching roof Limbs diameter < 3" Limbs diameter 3" or more
58. Playground equipment
59. Junk car(s) 60. Appliance(s) 61.
Trip or fall hazard(s)Lumber
62. Housekeeping 63. Property for sale 64. Property for rent
65. Chimney concern(s) 66. 67. Lack of landscape maintenance 68. Tree house(s) 69. Exterior electrical concern(s)
PROTECTION 70. Dwelling on unpaved road: Mile(s) from pavement: < 1 1 - 5 > 5 71. Number of other permanent residences within view of dwelling: None 1 - 2 3 - 4 5 - 6 More than 6 72. Dwelling located on beachfront within 250 feet of ocean/gulf 73. Dwelling located on more than 5 acres 74. Dwelling located in secured subdivision. 74A. Secured by: Attended guard house Unattended guard house Keypad and gate only
Historical district
Asbestos shingle Metal (corrugated) Metal (tin)
75. If dwelling is located in secured subdivision, single entrance only.
L1/S
15'
29'
15'
16'
25'
28'
17' SP
10'
PC 14'
AG
8'
22'
23'
OP 6'
6'
SPE
31'
14'
37'
17'
Name PAULA SANTIAGO Reference Number 16-102-000587 Policy Number FLP251922
(C) 2006 - 2014 National Risk Services, Inc.
Area Name Sign Multiplier Perimeter (ft.) Area Value (sq. ft.) Living Area L1/S + 1 182 1303 Summary Living Area 1303 sq.ft. Porch Area SP + 1 48 140 OP + 1 24 36 SPE + 1 108 611 Summary Porch Area 787 sq.ft. Patio/Deck Area PC + 1 70 294 Summary Patio/Deck Area 294 sq.ft. Garage Area AG + 1 90 506 Summary Garage Area 506 sq.ft.
Agent Phone:
Agent:
Company:
Pol. #:
Zip:State:City:
Location:
Insured:
Photo Sheet
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
Photo Description:
Photo Description:
Address
Front
PAULA SANTIAGO
1576 ROSERY RD NE
LARGO FL 33770
FLP251922
ASI PREFERRED
THE AUTO CLUB GROUP
(800) 8914222 Ext.
Agent Phone:
Agent:
Company:
Pol. #:
Zip:State:City:
Location:
Insured:
Photo Sheet
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
Photo Description:
Photo Description:
Rear
Left
PAULA SANTIAGO
1576 ROSERY RD NE
LARGO FL 33770
FLP251922
ASI PREFERRED
THE AUTO CLUB GROUP
(800) 8914222 Ext.
Agent Phone:
Agent:
Company:
Pol. #:
Zip:State:City:
Location:
Insured:
Photo Sheet
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
Photo Description:
Photo Description:
Right
Tree limbs overhanging
PAULA SANTIAGO
1576 ROSERY RD NE
LARGO FL 33770
FLP251922
ASI PREFERRED
THE AUTO CLUB GROUP
(800) 8914222 Ext.
Agent Phone:
Agent:
Company:
Pol. #:
Zip:State:City:
Location:
Insured:
Photo Sheet
YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.
Photo Description:
Photo Description:
Tree limbs overhanging
Pool
PAULA SANTIAGO
1576 ROSERY RD NE
LARGO FL 33770
FLP251922
ASI PREFERRED
THE AUTO CLUB GROUP
(800) 8914222 Ext.