BUILDING IDENTIFICATION AND DATA SHEET

ADA Build it Right, Inc.

Facility Name:	______________________________________
Facility Address:	______________________________________
Date(s) of Construction:	______________________________________
Date(s) of Alteration:	______________________________________
Type of Facility or Building Use: (For example, is the building a place of public accommodation or commercial facility? Is it owned by a State or local government? Is it the professional office of a health care provider, a shopping center or a shopping mall, or a transportation facility?)
Number of Stories and Size of Each:	_________________________________________________
Name(s) of Surveyors:	_________________________________________________
Date(s) of Survey:	_________________________________________________