RENTER'S INSPECTION WORKSHEET

In anticipation of entering into a lease where Dorian Mayhew Rothschild (the "Landlord"), of 60
Arthur St., San Rafael, CA 94901 will rent to Ryan B. Jagger, (the "Tenant", of 35 Palm Circle
Dr., Corte Madera, CA 95422, the premises described as:
35 Palm Circle Dr.
Corte Madera, CA 95422
The parties have each examined the premises and each agrees that the specific items are in good,
clean and sanitary order, and in good condition and repair, unless noted to the contrary in this
checklist.
If the Landlord and Tenant do, in fact, enter into a Lease Agreement, then at the end of the lease
term, Tenant agrees to return the premises in a condition that matches the condition of the premises
at the beginning of the lease term, as reflected in this checklist, except for such deterioration that
might result from normal use of the premises and furnishings.
As part of the consideration for the rental of the premises, Tenant voluntarily assumes the risk of
any defects in the premises either known, or that should have been known to Tenant in the
exercise of ordinary care at the beginning of the lease term, unless the Tenant gives written notice
to Landlord to correct the defects, prior to entering into the Lease Agreement.

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KITCHEN
OK
(yes/no)
Floors clean
Carpet
Sink
Stopper
Strainer
Countertops
Cabinets
Exhaust fan works
Dishwasher
Refrigerator
Clean
Light
Trays and Shelves
Freezer
Microwave
Trash Compactor
Range
Range hood clean
Interior clean
Knobs
Pans/racks
Light switches
Bulbs
Windows
Screens
Drapes, curtains, blinds
Door
Locks
Latches
Surfaces
Walls
Ceiling
Smoke detector
Fire sprinkler, extinguisher

COMMENTS

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KITCHEN (continued)
OK
(yes/no)
Overall Cleanliness
Other:
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COMMENTS

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LIVING ROOM
OK
(yes/no)
Floors
Carpets
Lights
Windows
Screens
Walls
Ceiling
Drapes
Drapery rods
Blinds
Shades
Doors
Louvers intact
Locks
Latches
Surfaces
Doorstops
Fireplace
Flue clean
Ceiling fan
Smoke detector
Bookshelves
Light Switches
Overall Cleanliness
Other:
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COMMENTS

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BATHROOM 1
Location:_________________________________________
OK
(yes/no)
Toilet
Faucets
Sink
Stopper
Mirrors
Towel bars
Shower curtain rod
Shower curtain
Shower enclosure
Cabinet
Tile
Tile grouting
Tub caulking
Tub chips
Bulbs
Light Switches
Vent fan
Floors
Walls
Ceiling
Windows
Screens
Curtains
Blinds
Shades
Doors
Locks
Latches
Surfaces
Overall Cleanliness
Other:
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COMMENTS

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BATHROOM 2
Location:_________________________________________
OK
(yes/no)
Toilet
Faucets
Sink
Stopper
Mirrors
Towel bars
Shower curtain rod
Shower curtain
Shower enclosure
Cabinet
Tile
Tile grouting
Tub caulking
Tub chips
Bulbs
Light Switches
Vent fan
Floors
Walls
Ceiling
Windows
Screens
Curtains
Blinds
Shades
Doors
Locks
Latches
Surfaces
Overall Cleanliness
Other:
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COMMENTS

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BEDROOM 1
Location:_________________________________________
OK
(yes/no)
Walls
Floors
Carpets
Ceiling
Lights
Light Switches
Windows
Screens
Curtains
Blinds
Shades
Doors
Locks
Latches
Surfaces
Closets
Smoke alarm
Overall Cleanliness
Other:
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COMMENTS

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BEDROOM 2
Location:_________________________________________
OK
(yes/no)
Walls
Floors
Carpets
Ceiling
Lights
Light Switches
Windows
Screens
Curtains
Blinds
Shades
Doors
Locks
Latches
Surfaces
Closets
Smoke alarm
Overall Cleanliness
Other:
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COMMENTS

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BEDROOM 3
Location:_________________________________________
OK
(yes/no)
Walls
Floors
Carpets
Ceiling
Lights
Light Switches
Windows
Screens
Curtains
Blinds
Shades
Doors
Locks
Latches
Surfaces
Closets
Smoke alarm
Overall Cleanliness
Other:
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COMMENTS

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ELECTRICAL
OK
(yes/no)
Main panel
Circuits marked
Basement wiring
House wiring
Thermostat
Other:
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COMMENTS

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PLUMBING
OK
(yes/no)
Main valve
Interior pipes
Exterior faucets
freeze-proof
Private sewage system
Private well
Other:
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COMMENTS

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GARAGE
OK
(yes/no)
Side Door
Vehicle Door
Electric Opener
Serial Number
Tracks
Remote Opener-1
Remote Opener-2
Remote Opener-3
Stop/reverse function
Walls
Windows
Floor
Curtains
Cabinet
Light switches
Bulbs
Screens
Overall Cleanliness
Floor drain
Other:
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COMMENTS

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Landlord and Tenant hereby acknowledge that they have each read this checklist and agree that
the condition and contents of the above-mentioned rental dwelling are, without exception, as
represented in this checklist. Tenant understands that Tenant is liable for any damage done to this
dwelling as outlined in the Lease Agreement. Both parties acknowledge receiving a copy of this
checklist.
LANDLORD:
Dorian Mayhew Rothschild

_________________________________ Date: ________________

Dorian Mayhew Rothschild

TENANT:
Ryan B. Jagger

_________________________________ Date: ________________

Ryan B. Jagger

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