<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class="container"> <div class="row"> <div class="col-md-3"> </div> <div class="col-md-1"> Yes </div> <div class="col-md-1"> NO </div> <div class="col-md-1"> UnKnown </div> <div class="col-md-3"> </div> <div class="col-md-3"> </div> </div> <div class="row"><br></div> <div class="row"> <div class="col-md-3"> <label> Is Uniform Code or Energy Code variance required?*</label> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-3"> </div> <div class="col-md-3"> </div> </div> <div class="row"><br></div> <div class="row"> <div class="col-md-3"> <label> Has the Variance been applied for?*</label> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-3"> <input type="text" class="form-control" /> </div> <div class="col-md-3"> Please enter the reason </div> </div> <div class="row"><br></div> <div class="row"> <div class="col-md-3"> <label>Is there a petition number available?*</label> </div> <div class="col-md-1"> <input type="radio" class="form-check-input" /> </div> <div class="col-md-1"> <input type="radio" class="form-check-input" /> </div> <div class="col-md-1"> <input type="radio" class="form-check-input" /> </div> <div class="col-md-3"> <input type="text" class="form-control" /> </div> <div class="col-md-3"> Please enter the reason </div> </div> <div class="row"><br></div> <div class="row"> <div class="col-md-3"> <label>Was the variance application approved?*</label> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-3"> <input type="checkbox" /> Triggers determination prior to submission </div> <div class="col-md-3"> Upload </div> </div> <div class="row"><br></div> <div class="row"> <div class="col-md-3"> <label> Are there any previous variances on this property?*</label> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-1"> <input type="radio" /> </div> <div class="col-md-3"> <input type="checkbox" /> Triggers determination prior to submission </div> <div class="col-md-3"> Upload </div> </div> <div class="row"><br></div> <div class="row" style="height:50px;"><br></div> <div class="row"> <div class="col-md-3"> </div> <div class="col-md-1"> </div> <div class="col-md-1"> </div> <div class="col-md-1"> </div> <div class="col-md-3"> </div> <div class="col-md-3"> Comments(Applicant) <input type="text" multiline="true" style="height:50px" class="form-control" /> </div> </div> <div class="row"><br></div><div class="row"> <div class="col-md-3"> </div> <div class="col-md-1"> </div> <div class="col-md-1"> </div> <div class="col-md-1"> </div> <div class="col-md-3"> </div> <div class="col-md-3"> Comments(Reviewer) <input type="text" multiline="true" style="height:50px" class="form-control" /> </div> </div> </div>