| Project Name: Remodel to Accommodate a Disability |
| Project Location: Queen Creek, AZ |
| Date: 01/24/2010 |
| Consumer Owns Home: Yes |
| Kind of Residence: One-story single family home |
| Nature of Disability: Impaired hearing |
| Nature of Disability: Impaired strength/motion range (reaching, bending, lifting) |
| Nature of Disability: Impaired vision |
| Nature of Disability: Loss of balance, coordination |
| Nature of Disability: Sense of smell |
| Nature of Disability: Walker |
| Nature of Disability: Wheelchair |
| Remodeling Needs: Bathroom(s) |
| Remodeling Needs: Bedroom(s) |
| Remodeling Needs: Create/change special quarters within residence |
| Remodeling Needs: Flooring |
| Remodeling Needs: Interior doorway(s) |
| Changes in Bathroom: Other |
| Changes in Bathroom: Toilet upgrade |
| Changes in Kitchen: Add/change lighting |
| Changes in Kitchen: Change faucets |
| Changes in Kitchen: Change/modify countertop |
| Changes in Kitchen: Other |
| Changes in Kitchen: Would appreciate suggestions |
| Request is for Commercial Location: No |
| Covered by Insurance: No |
| Desired Completion Date: Timing is flexible |
| Request Stage: Planning & Budgeting |
| Comment: my mother is 85 and needs assistance 24/7. she is independent but with help. a walk in tub is the most important and wider door ways. if possible wood type flooring to replace the carpet. |