<!-- Begin Body --> 
<?php $currentUser 		= $_SESSION['danvillee_username']; ?>
<form  role="form" id="buyer_house_renovation_monitoring_form" class="form-horizontal">
<div class="container-fluid" style="padding-top:120px; height:550px">
	<div class="row"><br/></div>
	<div class="row">
		<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
			<fieldset>
				<input type="hidden" id="current_user" value="<?=$currentUser?>"> 
				<div class="form-group"> 
					<label class="col-md-5 control-label text-right" for="bsm_fullname"><small>Full Name</small></label>
					<div class="col-md-7"><input type="text" id="bsm_fullname" readonly placeholder="Full Name" value="" class="form-control text-left"></div>
				</div>
				
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bsm_phase"><small>Phase</small></label>
					<div class="col-md-7"><input type="text" id="bsm_phase" readonly placeholder="Phase" value="" class="form-control text-left"></div>
				</div>
				 
				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bsm_permit_to_construct_no"><small>Permit to Construct No </small></label>
					<div class="col-md-7"><input type="text" id="bsm_permit_to_construct_no" name="bsm_permit_to_construct_no" placeholder="" value="" class="form-control text-right"   onkeypress="return isNumberKey(event)"></div>
				</div>

				<div class="form-group">
					<label class="col-md-5 control-label text-right"><small>&nbsp;<br/></small></label>
					<div class="col-md-7"><input type="hidden" class="form-control"><br/></div>
				</div>

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bsm_construction_bond_paid_amount"><small>Construction Bond</small></label>
					<div class="col-md-7">
					<input type="text" id="bsm_construction_bond_paid_amount" name="bsm_construction_bond_paid_amount" placeholder="0.00" value="" class="form-control text-right" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event);">
					</div>
				</div> 

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bsm_construction_bond_paid"><small>Date Paid</small></label>
					<div class="col-md-7">
					<input type="text" id="bsm_construction_bond_paid" name="bsm_construction_bond_paid" placeholder="MM/DD/YYYY" value="" class="form-control text-right datepicker">
					</div>
				</div> 

				<div class="form-group">
					<label class="col-md-5 control-label text-right" for="bsm_payment_details"><small>Payment Details</small></label>
					<div class="col-md-7">
					<input type="text" id="bsm_payment_details" name="bsm_payment_details" placeholder="" value="" class="form-control">
					</div>
				</div> 

			</fieldset>
		</div>
		<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
			<fieldset> 
				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_take_out_date"><small>Take-out Date</small></label>
					<div class="col-md-6">
					<input type="text" id="bsm_take_out_date" name="bsm_take_out_date" placeholder="MM/DD/YYYY" value="" class="form-control text-right"  readonly>
					</div>
				</div>
				
				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_block"><small>Block</small></label>
					<div class="col-md-6"><input type="text" id="bsm_block" readonly placeholder="Block" value="" class="form-control text-left"></div>
				</div>
				
				
				
				
				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_fullrefund_or_withviolation"><small>Refund</small></label>
					
					
					<div class="col-md-6" id="accounting_on">
						<select id="bsm_fullrefund_or_withviolation"  name="bsm_fullrefund_or_withviolation" class="form-control select2">
							<option value=""></option>
							<option value="Full Refund">Full Refund</option>
							<option value="With Violation">With Violation</option>
						</select>
					</div>

					<div class="col-md-6" id="accounting_off">
						<input type="text" id="bsm_fullrefund_or_withviolation1" value="" name="bsm_fullrefund_or_withviolation1" class="form-control" readonly> 
					</div>
				</div> 
				
				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_penalty"><small>Penalty </small></label>
					<div class="col-md-6">
						<input type="text"  onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event)" id="bsm_penalty" name="bsm_penalty" placeholder="0.00" value="" class="form-control text-right" >
					</div>
				</div> 
				
				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_amount"><small>Net Refund </small></label>
					<div class="col-md-6">
						<input type="text" onblur = "javascript:this.value=Comma(this.value);" onkeypress="return isNumberKey(event)" id="bsm_amount" name="bsm_amount" placeholder="0.00" value="" class="form-control text-right" >
					</div>
				</div> 

				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_refund_date"><small>Refund Date</small></label>
					<div class="col-md-6"><input type="text" id="bsm_refund_date" name="bsm_refund_date" placeholder="MM/DD/YYYY" value="" class="form-control text-right datepicker" ></div>
				</div>

				<div class="form-group">
					<label class="col-md-6 control-label text-right" for="bsm_check_release_details"><small>Check Release Details</small></label>
					<div class="col-md-6">
					<input type="text" id="bsm_check_release_details" name="bsm_check_release_details" placeholder="" value="" class="form-control">
					</div>
				</div> 

			</fieldset>
		</div>
		<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
			<fieldset>
				<div class="form-group">
					<div class="col-md-8"><br/><br/></div>
				</div>
				<div class="form-group">
					<label class="col-md-4 control-label text-right" for="bsm_lot"><small>Lot</small></label>
					<div class="col-md-8"><input type="text" id="bsm_lot" readonly placeholder="Lot" value="" class="form-control text-left"></div>
				</div>	

				<div class="form-group"> 
					<label class="col-md-4"></label>
					<div class="col-md-8"><textarea rows="8" id="bsm_remarks2" class="form-control" name="bsm_remarks2" placeholder="Nature of Violation if any"></textarea></div>
				</div>		
				 
				
				 
			</fieldset>
		</div>
	</div>

	<div class="row">
		<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
				<div class="form-group">
					<label class="col-md-12 control-label text-left left" for="bsm_remarks" style="text-align:left !important"><small class="text-left" style="text-align:left !important">Remarks</small></label>
					<div class="col-md-12"><textarea rows="2" id="bsm_remarks" class="form-control" name="bsm_remarks" placeholder="If required by local government, name of contractor for House Improvement:_______"></textarea></div>
				</div>
		</div>
	</div>
	 
	  
	  
</div>
</form>

