Certified Chimney Inspectors, Inc.

hank you for calling on CCI for your chimney inspection. Please fill in all the applicable information below and we will get back to you within 24 hrs. If you need to reach someone immediately, feel free to give us a call at (818) 248-7300.

We look forward to serving you.

CLIENT:

Home Phone:			Work Phone:
Cell Phone:			Fax:
Email:
(If other than agent/client) Contact:			Contact Email:
			Contact Cell:

Property
Address:

City:

Zip:

Cross Street:

# of Chimneys:			Type:
# of Fireplaces:
# of Stories:

Agent:

Company:

Phone:			Cell Phone:
Fax:			Email:

Desired Appointment Date:

(Mon-Sat)

Desired Appointment Time:

(9am-4pm)

Referred By:

Additional Notes or Comments:

Phone: (818) 248-7300		Fax: (818) 248-7313
info@chimneyinspectors.com