Free 4 Point Inspection PDF Form Get Document

Free 4 Point Inspection PDF Form

The 4 Point Inspection Form is a crucial document used to assess the condition of a property's roof, electrical, HVAC, and plumbing systems. This form must be completed by a licensed inspector in Florida and is essential for determining insurability. To ensure a smooth process, fill out the form by clicking the button below.

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Outline

When it comes to securing homeowners insurance in Florida, the 4-Point Inspection Form plays a crucial role in assessing the condition of key systems within a property. This form is designed to evaluate four essential components: the roof, electrical system, HVAC (heating, ventilation, and air conditioning), and plumbing. Each section of the form requires detailed information and documentation, including photographs of the dwelling, roof slopes, and specific plumbing and electrical components. A licensed inspector must complete the form, ensuring that the information provided is accurate and reliable. This inspection not only identifies any visible hazards or deficiencies but also helps determine the insurability of the property. For instance, the electrical section requires insights into the type of wiring and any potential issues, while the plumbing section assesses the condition of fixtures and the presence of leaks. The roof evaluation focuses on its age, materials, and overall condition, which can significantly impact insurance coverage. By thoroughly documenting these aspects, the 4-Point Inspection Form serves as a vital tool for both homeowners and insurance providers in making informed decisions about coverage and risk management.

Key takeaways

  • Ensure that the 4-Point Inspection Form is filled out completely, providing accurate details about the property, including the insured/applicant's name and the address inspected.

  • Attach the required photos for each section of the inspection, including the dwelling, roof slopes, plumbing, and electrical panels. These visuals are crucial for documentation.

  • All inspections must be performed by a Florida-licensed inspector. Only licensed professionals can certify the condition of the roof, electrical, HVAC, and plumbing systems.

  • When documenting the electrical system, include specific details about any aluminum wiring remediation. This information is essential for underwriting considerations.

  • Clearly indicate the condition of each system on the form. Use terms like satisfactory or unsatisfactory to describe the overall status and any visible hazards or deficiencies.

  • Complete the Additional Comments/Observations section thoroughly if any updates, hazards, or deficiencies are noted. This section helps provide context for the inspection results.

  • Review the form carefully before submission. Ensure that all information is accurate and that no required details are missing, as this can affect the insurability of the property.

  • Remember that the 4-Point Inspection Form is not a warranty. It is used solely to determine the insurability of the property and does not guarantee the longevity or fitness of the inspected systems.

Form Preview Example

4-Point Inspection Form

Insured/Applicant Name:_________________________________________________ Application / Policy #:__________________________

Address Inspected:___________________________________________________________________________________________________

Actual Year Built:________________________

Date Inspected: ______________________________________________

 

 

Minimum Photo Requirements:

 

Dwelling: Each side

Roof: Each slope

Plumbing: Water heater, under cabinet plumbing/drains, exposed valves

Main electrical service panel with interior door label

Electrical box with panel off

All hazards or deficiencies noted in this report

A Florida-licensed inspector must complete, sign and date this form.

Be advised that Underwriting will rely on the information in this sample form, or a similar form, that is obtained from the Florida licensed professional of your choice. This information only is used to determine insurability and is not a warranty or assurance of the suitability, fitness or longevity of any of the systems inspected.

Electrical System

Separate documentation of any aluminum wiring remediation must be provided and certified by a licensed electrician.

Main Panel

 

 

Second Panel

 

Type:

Circuit breaker

Fuse

 

Type:

Circuit breaker Fuse

 

Total Amps: __________

 

 

Total Amps: __________

 

Is amperage sufficient for current usage?

Yes No (explain)

Is amperage sufficient for current usage?

Yes No (explain)

 

 

 

 

 

 

 

Indicate presence of any of the following:

Cloth wiring

Active knob and tube

Branch circuit aluminum wiring (If present, describe the usage of all aluminum wiring):

* If single strand (aluminum branch) wiring, provide details of all remediation. Separate documentation of all work must be provided.

Connections repaired via COPALUM crimp Connections repaired via AlumiConn

Hazards Present

 

 

Double taps

Blowing fuses

 

 

Exposed wiring

Tripping breakers

 

 

Unsafe wiring

Empty sockets

 

 

Improper breaker size

Loose wiring

 

 

Scorching

Improper grounding

 

 

Other (explain)

Corrosion

 

 

 

Over fusing

 

 

 

 

 

 

 

General condition of the electrical system:

Satisfactory

Unsatisfactory (explain)

Supplemental information

Main Panel

Second Panel

Wiring Type

Panel age: __________

Panel age: __________

Copper

Year last updated: __________

Year last updated:__________

NM, BX or Conduit

Brand/Model: __________

Brand/Model: __________

 

 

 

 

Sample Form Insp4pt 01 18

4-Point Inspection Form

HVAC System

Central AC:

Yes

No

Central heat:

Yes

No

If not central heat, indicate primary heat source and fuel type: _________________________________

Are the heating, ventilation and air conditioning systems in good working order?

Yes

No (explain)

Date of last HVAC servicing/inspection: ______________

 

 

 

 

 

 

 

 

 

 

 

 

Hazards Present

 

 

 

 

 

 

 

Wood-burning stove or central gas fireplace not professionally installed?

Yes

No

 

Space heater used as primary heat source?

Yes

No

 

 

 

Is the source portable?

Yes

No

 

 

 

 

 

Does the air handler/condensate line or drain pan show any signs of blockage or leakage, including water damage to the surrounding area?

Yes No

Supplemental Information

Age of system: _____________

Year last updated: _____________

(Please attach photo(s) of HVAC equipment, including dated manufacturer’s plate)

Plumbing System

Is there a temperature pressure relief valve on the water heater?

Yes

No

 

Is there any indication of an active leak?

Yes

No

 

 

 

Is there any indication of a prior leak?

Yes

No

 

 

 

Water heater location: _______________________________________________

 

 

 

 

General condition of the following plumbing fixtures and connections to appliances:

 

Satisfactory Unsatisfactory

N/A

 

Satisfactory Unsatisfactory

N/A

 

Dishwasher

 

 

 

Toilets

 

Refrigerator

 

 

 

Sinks

 

Washing machine

 

 

 

Sump pump

 

Water heater

 

 

 

Main shut off valve

 

Showers/Tubs

 

 

 

All other visible

 

 

 

 

 

 

 

If unsatisfactory, please provide comments/details (leaks, wet/soft spots, mold, corrosion, grout/caulk, etc.).

Supplemental Information

Age of Piping System:

 

Type of pipes (check all that apply)

 

_____

Original to home

 

Copper

 

 

 

 

 

_____

Completely re-piped

 

PVC/CPVC

 

 

 

 

 

_____

Partially re-piped

 

Galvanized

 

 

 

 

 

(Provide year and extent of renovation in the comments below)

 

PEX

 

 

 

 

 

 

 

 

Polybutylene

 

 

 

 

Other (specify)

 

 

 

 

 

 

Sample Form Insp4pt 01 18

4-Point Inspection Form

Roof (With photos of each roof slope, this section can take the place of the Roof Inspection Form.)

Predominant Roof

Covering material: __________

Roof age (years): __________

Remaining useful life (years): __________

Date of last roofing permit: __________

Date of last update: __________

If updated (check one):

Full replacement Partial replacement

%of replacement: __________

Overall condition:

Satisfactory

Unsatisfactory (explain below)

Any visible signs of damage / deterioration?

(check all that apply and explain below)

Cracking

Cupping/curling

Excessive granule loss

Exposed asphalt

Exposed felt

Missing/loose/cracked tabs or tiles

Soft spots in decking Visible hail damage

Any visible signs of leaks? Yes No

Attic/underside of decking Yes No

Interior ceilings Yes No

Secondary Roof

Covering material: __________

Roof age (years): __________

Remaining useful life (years): __________

Date of last roofing permit: __________

Date of last update: __________

If updated (check one):

Full replacement Partial replacement

%of replacement: __________

Overall condition:

Satisfactory

Unsatisfactory (explain below)

Any visible signs of damage / deterioration?

(check all that apply and explain below)

Cracking

Cupping/curling

Excessive granule loss

Exposed asphalt

Exposed felt

Missing/loose/cracked tabs or tiles

Soft spots in decking Visible hail damage

Any visible signs of leaks? Yes No

Attic/underside of decking Yes No

Interior ceilings Yes No

Additional Comments/Observations (use additional pages if needed):

All 4-Point Inspection Forms must be completed and signed by a verifiable Florida-licensed inspector. I certify that the above statements are true and correct.

Inspector Signature

 

Title

 

License Number

 

Date

 

 

 

 

 

 

 

Company Name

 

License Type

 

Work Phone

 

 

Sample Form Insp4pt 01 18

4-Point Inspection Form

Special Instructions: This sample 4-Point Inspection Form includes the minimum data needed for Underwriting to properly evaluate a property application. While this specific form is not required, any other inspection report submitted for consideration must include at least this level of detail to be acceptable.

Photo Requirements

Photos must accompany each 4-Point Inspection Form. The minimum photo requirements include:

Dwelling: Each side

Roof: Each slope

Plumbing: Water heater, under cabinet plumbing/drains, exposed valves

Open main electrical panel and interior door

Electrical box with the panel off

All hazards or deficiencies

Inspector Requirements

To be accepted, all inspection forms must be completed, signed and dated by a verifiable Florida-licensed professional. Examples include:

A general, residential, or building contractor

A building code inspector

A home inspector

Note: A trade-specific, licensed professional may sign off only on the inspection form section for their trade. (e.g., an electrician may sign off only on the electrical section of the form.)

Documenting the Condition of Each System

The Florida-licensed inspector is required to certify the condition of the roof, electrical, HVAC and plumbing systems. Acceptable Condition means that each system is working as intended and there are no visible hazards or deficiencies.

Additional Comments or Observations

This section of the 4-Point Inspection Form must be completed with full details/descriptions if any of the following are noted on the inspection:

Updates: Identify the types of updates, dates completed and by whom

Any visible hazards or deficiencies

Any system determined not to be in good working order

Note to All Agents

The writing agent must review each 4-Point Inspection Form before it is submitted with an application for coverage. It is the agent’s responsibility to ensure that all rules and requirements are met before the application is bound. Agents may not submit applications for properties with electrical, heating or plumbing systems not in good working order or with existing hazards/deficiencies.

Sample Form Insp4pt 01 18