Fillable OMB Control No. 2502-0313 (exp. 10/31/2020) (Web Master Pulic Affair)

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OMB Control No. 2502-0313 (exp. 10/31/2020) (Web Master Pulic Affair)

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BROWSE WEB MASTER PULIC AFFAIR (DC) FORMS

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Description of Materials
U.S. Department of Housing
and Urban Development
Department of Veterans Affairs
Farmers Home Administration
OMB Control No. 2502-0313
(exp. 10/31/2020)
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not collect
this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
The National Housing Act (12 USC 1703) authorizes insuring financial institutions against default losses on single family mortgages. HUD must evaluate the
acceptability and value of properties to be insured. The information collected here will be used to determine if proposed construction meets regulatory
requirements and if the property is suitable for mortgage insurance. Response to this information collection is mandatory. No assurance of confidentiality
is provided.
Proposed Construction Under Construction No. (To be inserted by HUD, VA or FmHA)
Property address (Include City and State)
Name and address of Mortgagor or Sponsor
Name and address of Contractor or Builder
Instructions
1. For additional information on how this form is to be submitted, number of
copies, etc., see the instructions applicable to the HUD Application for
Mortgage Insurance, VA Request for Determination of Reasonable Value,
or FmHA Property Information and Appraisal Report, as the case may be.
2. Describe all materials and equipment to be used, whether or not shown on
the drawings, by marking an X in each appropriate check-box and entering
the information called for each space. If space is inadequate, enter “See
misc.” and describe under item 27 or on an attached sheet. The use of
paint containing more than the percentage of lead by weight
permitted by law is prohibiited.
1. Excavation
3. Work not specifically described or shown will not be considered unless
required, then the minimum acceptable will be assumed. Work exceeding
minimum requirements cannot be considered unless specifically described.
4. Include no alternates, “or equal” phrases, or contradictory items. (Consid-
eration of a request for acceptance of substitute materials or equipment is
not thereby precluded.)
5. Include signatures required at the end of this form.
6. The construction shall be completed in compliance with the related drawings
and specifications, as amended during processing. The specifications include
this Description of Materials and the applicable Minimum Property Standards.
Bearing soil, type ___________________________________________________________________________________________________________
2. Foundations
Footings concrete mix _____________________________ ____ strength psi _______________ _ Reinforcing ________________________________
Foundation wall material _______________________________________ Reinforcing ________________________________
Interior foundation wall material __________________________________ Party foundation wall ____________________________________________
Columns material and sizes _____________________________________ Piers material and reinforcing _____________________________________
Girders material and sizes ______________________________________ Sills material ___________________________________________________
Basement entrance areaway _____________________________________Window areaways ______________________________________________
Waterproofing ________________________________________________ Footing drains _________________________________________________
Termite protection ___________________________________________________________________________________________________________
Basementless space ground cover _________________________ insulation ______________________ foundation vents ____________________
Special foundations __________________________________________________________________________________________________________
Additional information
3. Chimneys
Material _____________________________________ _Prefabricated (make and size) ___________________________________________________
Flue lining material ____________________________ _Heater flue size ________________________ _Fireplace flue size _____________________
Vents (material and size) gas or oil heater ______________________________________ _ water heater _____________________________________
Additional information
4. Fireplaces
Type solid fuel gas-burning circulator (make and size) _______________________________ Ash dump and clean-out_______
Fireplace facing ____________________ __ lining _______________________ _ hearth ___________________ _ mantel _____________________
Additional information
Retain this record for three years Page 1 of 6
ref. HUD Handbook 4001 form HUD-92005 (10/2017)
VA Form 26-1852 and form FmHA 424-2
Clear Page
Additional information
Retain this record for three years Page 2 of 6
Rooms
Grade
Species
Thickness
Width
Bldg. Paper
sq. ft.
Clear Page
13. Gutters and Downspouts
Gutters material ___________________________ gage or weight ___________ _ size _________ shape ________________________________
Downspouts material _______________________ gage or weight ___________ _ size _________ shape _______________ number ________
Downspouts connected to Storm sewer sanitary sewer dry-well Splash blocks material and size _______________________
Additional information
14. Lath and Plaster
Lath walls ceilings material _______________ weight or thickness __________ Plaster coats _____ finish ______________________
Dry-wall walls ceilings material ________________________ thickness _______ finish ______________________
Joint treatment
15. Decorating (Paint, wallpaper, etc.)
Rooms Ceiling Finish Material and Application
Kitchen
Bath
Other
Additional information
16. Interior Doors and Trim
Doors type __________________________________________________material ________________________________thickness _______________
Door trim type ___________________ material _________________ _Base type ________________ material _______________ size ________
Finish doors ___________________________________________________ trim _________________________________________________________
Other trim (item, type and location) _____________________________________________________________________________________________
Additional information
17. Windows
Windows type ___________________ make _______________________ _material _________________________ sash thickness ____________
Glass grade ___________________ sash weights balances, type ________________________ head flashing ______________
Trim type ______________________ material ____________________________Paint _______________________ _ number coats ___________
Weatherstripping type _______________________________________ material _______________________________ Storm sash, number _______
Screens full half type ___________________________ _ number _________ _ screen cloth material ____________________________
Basement windows type ___________________ material ___________________ screens, number ___________ _ Storm sash, number _______
Special windows _____________________________________________________
Additional information
18. Entrances and Exterior Detail
Main entrance door material _____________________ _width ________ thickness _____ Frame material ______________ _thickness ______
Other entrance doors material _____________________ _width ________ thickness _____ Frame material ______________ _thickness ______
Head flashing ___________________________________ Weatherstripping type _________________________ _ saddles _____________________
Screen doors thickness ________ number __________ screen cloth material _______________Storm doors thickness ______ number ________
Combination storm and screen doors thickness ________number _______ screen cloth material ___________________________________ _____
Shutters hinged fixed Railings ________________________________ Attic louvers ______________
Exterior millwork grade and species ____________________________________ Paint ____________________________ _ number coats ________
Additional information
19. Cabinets and Interior Detail
Kitchen cabinets, wall units material ________________________________________________ lineal feet of shelves _______ _shelf width _________
Base units material _____________________________ _ counter top _____________________________ edging _________________________
Back and end splash ____________________________ Finish of cabinets _____________________________________ number coats ________
Medicine cabinets make ____________________________________________ model _________________________________________________
Other cabinets and built-in furniture ____________________________________________________________________________________________
Additional information
Retain this record for three years Page 3 of 6
ref. HUD Handbook 4145.1 & 4950.1 form HUD-92005 (10/2017)
VA Form 26-1852 and form FmHA 424-2
Wall Finish Material and Application
Clear Page
FloorsWainscot
20. Stairs
Balusters
Stair Size
Basement
Main
Attic
Disappearing make and model number ________________________________________________________________________________________
Additional information
21. Special Floors and Wainscot (Describe Carpet as listed in Certified Products Directory)
Underfloor
Material
Height in Showers
(From Floor)
Additional information
22. Plumbing
Fixture Color
Sink
Lavatory
Water closet
Bathtub
Shower over tub
Stall shower
Laundry trays
Bathroom accessories Recessed material ________________ number ________ Attached material __________ _ number _________
Additional information
Curtain rod Door Shower pan material _________________________________________________________________________
parate
Water supply public community system individual (private) system*
Sewage disposal public community system individual (private) system*
drawings and specifications according to requirements.)
House drain (inside) cast iron tile other _________________ House sewer (outside) cast iron tile other _________
Water piping galvanized steel copper tubing other ____________________________ _______ Sill cocks, number ___________
Domestic water heater type ___________________ make and model ________________________ heating capacity _______________ gph. 100° rise.
Storage tank material ________________________________________ capacity __________ gallons
Gas service utility company liq. pet. gas other _____________________________ Gas piping cooking house heating
Footing drains connected to storm sewer sanitary sewer dry well Sump pump make and model __________________________
capacity _____________________________ discharges into _________________________________________
Additional information
Retain this record for three years Page 4 of 6
ref. HUD Handbook 4145.1 & 4950.1 form HUD-92005 (10/2017)
VA Form 26-1852 and form FmHA 424-2
Treads
Risers
Strings
Handrail
Material
Thickness
Material
Thickness
Material
Size
Material
Size
Material
Location
Material, Color, Border, Sizes, Gage, Etc.
Threshold
Material
Wall Base
Material
Kitchen
Bath
Location
Material, Color, Border, Cap. Sizes, Gage, Etc.
Height
Height
Over Tub
Bath
Number
Location
Make
MFR's Fixture Identification No.
Size
* (Show and describe individual system in complete detail in se
Clear Page
23. Heating
Hot water Steam Vapor One-pipe system Two-pipe system
Radiators Convectors Baseboard radiation Make and model _______________________________________________________
Radiant panel floor wall ceiling Panel coil material _______________________________________________________
Circulator Return pump Make and model ___________________________________________________ capacity _________ gpm.
Boiler make and model ______________________________________________ Output _______________ Btuh. net rating ___________ Btuh.
Additional information
Warm air Gravity Forced Type of system ____________________________________________________________________________
Duct material supply _________________ return _________________ _ Insulation __________ thickness ________ Outside air intake
Furnace: make and model ______________________________________________ Input _______________ Btuh. output ______________ Btuh.
Additional information
Space heater floor furnace wall heater Input _______________ Btuh. output _______________ Btuh. number units ______________
Make, model __________________________________
Additional information
Controls make and types _____________________________________________________________________________________________________
Additional information
Fuel: Coal oil gas liq. pet. gas electric other _________________________ storage capacity _____________
Additional information
Firing equipment furnished separately Gas burner, conversion type Stoker hopper feed bin feed
Oil burner pressure atomizing vaporizing __________________________________________________________________________________
Make and model ___________________________________________________________________________________________________________
Control ____________________________________________________________________________________________________________________
Additional information
Electric heating system type _________________________________________ Input ________ watts @ ________ volts output ____________ Btuh.
Additional information
Ventilating equipment attic fan, make and model _________________________________________________ capacity __________ cfm.
kitchen exhaust fan, make and model _______________________________________________________________
Other heating, ventilating, or cooling equipment __________________________________________________________________________________
Additional information
24. Electric Wiring
Service overhead underground Panel fuse box circuit-breaker make _______________ AMP's _______ No. circuits ___
Wiring conduit armored cable nonmetallic cable knob and tube other ______________________________________
Special outlets range water heater other ____________________________________________________________
Doorbell Chimes Push-button locations __________________________________________________________________________
Additional information
25.Lighting Fixtures
Total number of fixtures ________________ Total allowance for fixtures, typical installation, $ _____________________
Nontypical installation ______________________________________________________________________________________________________
Additional information
Retain this record for three years Page 5 of 6
ref. HUD Handbook 4145.1 & 4950.1 form HUD-92005 (10/2017)
VA Form 26-1852 and form FmHA 424-2
Clear Page
26. Insulation
Location Vapor Barrier
Roof
Ceiling
Wall
Floor
27. Miscellaneous: (Describe any main dwelling materials, equipment, or construction items not shown elsewhere; or use to provide additional information
where the space provided was inadequate. Always reference by item number to correspond to numbering used on this form.)
Hardware (make, material, and finish.)
Special Equipment (State material or make, model and quantity. Include only equipment and appliances which are acceptable by local law, custom and
applicable FHA standards. Do not include items which, by established custom, are supplied by occupant and removed when he vacates premises or chattles
prohibited by law from becoming realty.)
Porches
Terraces
Garages
Walks and Driveways
Driveway width _________ base material __________________ thickness _______ surfacing material _____________________ thickness ______
Front walk width ________ material ______________ _ thickness _______ Service walk width _______ material __________ _ thickness ______
Steps material ______________________________ _ treads _______ risers ______ Cheek walls ____________________________________
Other Onsite Improvements
(Specify all exterior onsite improvements not described elsewhere, including items such as unusual grading, drainage structures, retaining walls, fence,
railings, and accessory structures.)
Landscaping, Planting, and Finish Grading
Topsoil _______ thick front yard side yards rear yard to _________________ feet behind main building
Lawns (seeded, sodded, or sprigged) front yard _______________ ____ side yards _______________ rear yard ___________________
Planting as specified and shown on drawings as follows:
________Shade trees deciduous__________ caliper _________ Evergreen trees _____________ to _____________ B & B
________Low flowering trees deciduous _________ to _________ _________ Evergreen shrubs _____________ to _____________ B & B
________High-growing shrubs deciduous _________ to _________ _________ Vines, 2-year ____________________________________
________Medium-growing shrubs deciduous _________ to _________ Other
________Low-growing shrubs deciduous _________ to _________
Identification—This exhibit shall be identified by the signature of the builder, or sponsor, and/or the proposed mortgagor if the latter is known at the time
of application.
Date (mm/dd/yyyy)______________________________ Signature
Signature
Retain this record for three years Page 6 of 6
ref. HUD Handbook 4145.1 & 4950.1 form HUD-92005 (10/2017)
VA Form 26-1852 and form FmHA 424-2
Thickness
Material, Type, and Method of Installation
Clear Page
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OMB Control No. 2502-0313 (exp. 10312020) (Web Master Pulic Affair)

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Completed 5 March 2021

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