Custom Chimney Cap Worksheet Customer Chimney Cap Request Form Customer Name(Required) Email Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhonePurchase Order Number MaterialStainlessCopperOtherIf Other, which material? Powder Coated Yes No Screen Height (Measured in inches) 8 in. 10 in. 12 in. 14 in. 16 in. Other Cap NotesLid Overhang (Measured from screen to outer edge of lid in inches) 2 5 Other If Other, how many inches? Lid StyleFlat/BasicHip/Ridge with Standing SeamsHip/Ridge without Standing SeamsOtherIf Other, which lid style? Horizontal Skirt (Measured in inches) 2 in (Standard) 3 in 4 in 6 in Other Vertical Skirt (Measured in inches) 3 in (Standard) 4 in 5 in 6 in Other Width of the base (shorter side in inches) Length of the base (longer side in inches) Additional InformationConsent(Required) I agree to the privacy policy.PhoneThis field is for validation purposes and should be left unchanged. Δ
