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ICR 202610-0607-003 · OMB 0607-0110 · Object 174136500.
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Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | untitled |
| Last Modified By | Amgraf OneForm Designer Plus |
| File Modified | 2024-03-18 |
| File Created | 2011-11-07 |
| Conversion State | complete |
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FORM SOC-QI/SF.1 (04-07-2021) OMB No. 0607-0110: Approval Expires 03-31-2027 U.S. DEPARTMENT OF COMMERCE U.S. CENSUS BUREAU SURVEY OF CONSTRUCTION SINGLE-FAMILY BUILDINGS Title 13, United States Code (U.S.C.), Sections 131, 182, and 8(b), Title 12 U.S.C., Sections 1701z-1 and 1701z-2g, authorizes the Census Bureau to conduct this collection and to request your voluntary assistance. The U.S. Census Bureau is required by Section 9 of Title 13 to keep your information confidential and can use your responses only to produce statistics. The Census Bureau is not permitted to publicly release your responses in a way that could identify your business, organization, or institution. Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data. The eight-digit OMB number is 0607-0110 and appears in the upper right corner of this page. Without this approval, we cannot conduct this survey. We estimate this survey will take an average of 5 minutes to complete an interview. More information about this estimate and an address where you may write with comments is in the letter that accompanies this form. TO BE COMPLETED BY CENSUS FIELD REPRESENTATIVE Address or location of building Builder/Owner PSU SAMPLE FORM Permit Month Issued: Building permit number Project Name Day Year Block Lot BPOID Serving post office, State, ZIP Code RO TO BE COMPLETED BY RESPONDENT Month START_DATE Year MANUFACTURE Will this house be – When did excavation start for the footings or foundation of this house? EXCOMP_DATE Month Year 1 Modular? 3 Precut? 2 Panelized? 4 Site-built? FRAMING When do you expect to complete this house? Month COMP_DATE Year When was this house completed or occupied? What primary material is being used for the framing of this house? 1 SALE_CATEGORY 2 Is this house being built – 3 4 for sale or is it already sold? for the owner by a contractor on the owner’s land? 1 2 4 on owner’s land entirely by owner? for rent? 5 as part of Habitat for Humanity? 3 } 5 What type of foundation will this house have? ASSOCIATION 1 Was a deposit taken or a sales agreement signed for this house? 2 Yes No This a model home 2 3 } 3 Skip to 4 CONDO Month DEPOSIT_DATE Concrete/masonry other than insulated concrete forms Insulated concrete forms OR SIP Other – Specify FOUNDATION Skip to DEPOSIT 1 Wood Steel Year 5 Full or partial basement Will part or all of this basement be finished? 1 Yes – Skip to BASEMENTSQFOOT 2 No – Skip to TOTAL SQ FOOT TOTALSQFOOT Crawl space Slab Raised supports (pilings, piers, etc.) Other – Specify } Skip to TOTAL SQ FOOT TOTALSQFOOT When was a deposit taken or a sales agreement signed? BASEMENTSQFOOT CONDO What will be the square foot area of the finished part of the basement? Will this house be part of a condominium project? Yes 1 No 2 TOTALSQFOOT ASSOCIATION What will be the square foot area of completely finished floor space, including finished areas of the basement and attic? Will this house be part of a community or homeowner’s association? Yes 1 No 2 DIMENSQFOOT DEVELOPMENT Will this house be in a development that is age-restricted? Is the square footage based on interior or exterior dimensions? 1 1 Yes 2 No DETACHED Detached? 2 Exterior LOT_MEASUREMENT What is the size of the individual lot on which the house is being built? Will this house be – 1 Interior 2 Attached? SOC-QI/SF.1, Page 1, 100% BLACK INK PLEASE CONTINUE ON REVERSE SIDE SOC-QI/SF.1, Page 1, Pantone Reflex Blue, 100% and 20% tone STORIES PRIMARYSYSTEM How many stories, not including the basement, will be in this house? Which heating system will be used most in this house? CEILING HEIGHT What is the ceiling height on the first floor of this house (excluding two-story foyers and rooms with cathedral or vaulted ceilings)? feet (round to nearest whole foot) FOYER Will this house have a two-story foyer? 1 Yes No 2 How many of the following will be in this house? 4 5 6 3 5 Electric baseboard (including heat strips and wall panels) 7 Fireplace with insert 8 Solid fuel burning stove (including wood or coal stoves) 9 Liquid fuel burning stove 10 Passive solar system 11 No heat – Skip to AIRCONDITIONING 12 Other – Specify FULLBATHS What fuel will be used most for heating this house? Half Bathrooms HALFBATHS 1 Electricity FIREPLACES 2 Natural gas 3 Bottled or liquified petroleum gas (including propane) Oil (including heating oil or kerosene) Wood (including pellets) 4 5 Solar Coal Other – Specify 6 In the basement On the first floor 7 8 On the second or higher floor In the garage or carport AIRCONDITIONING Will this house have central air conditioning? No connection planned Multiple locations Yes 1 6 Wood or wood products 8 Stone, rock, or other stone materials Poured concrete or concrete block 9 Other – Specify 1 Public water (including community or shared water supply/well) 2 Individual well Other – Specify 3 SEWAGE What sewage disposal system will be used for this house? 1 PARKING 2 What type of parking will this house have? 3 1 2 3 4 5 6 A garage for 1 car A garage for 2 cars A garage for 3 or more cars Public sewers (including community or shared sewage/septic system) Individual septic system Other – Specify SALE_PRICE A carport Other off-street parking (driveway with no garage or carport) None of the above or CONTRACT_PRICE What is the sales price or contract price for this house? Decks 1 Yes 2 No DECKS Patios 1 Yes 2 No PATIOS Porches 1 Yes 2 No PORCHES $ LOT_VALUE What is the current market value of the improved lot? Will this house have any of the following? $ FINANCING Please visit our website at: www.census.gov/starts NOTES: No What water supply source will be used for this house? Vinyl siding (including vinyl-covered aluminum) Stucco Brick or brick veneer Fiber cement siding (such as Hardiplank or Hardiboard) 7 2 WATER Which wall material will cover most of the house when it is completed? 4 Hot water or steam (including hydronic systems) 6 Full Bathrooms PRIMARYWALL 2 Forced air furnace without heat pump 5 PRIMARYSOURCE Where will the washer and dryer connections be located in this house? 2 Heat pump, ground source (geothermal) 4 BEDROOMS LAUNDRY 3 Heat pump, air source (including reverse-cycle AC) Bedrooms Fireplaces 1 2 3 What type of financing was or will be arranged? 1 2 3 4 5 Conventional FHA VA Cash Other – Specify PLEASE RETAIN THIS FORM FOR YOUR USE WHEN CONTACTED BY YOUR CENSUS REPRESENTATIVE FORM SOC-QI/SF.1 (04-06-2018) SOC-QI/SF.1, Page 2, 100% BLACK INK SOC-QI/SF.1, Page 2, Pantone Reflex Blue, 100% and 20% tone