Printable 4 Point Inspection Template

The 4-Point Inspection Form is a crucial document used to assess the condition of a property's major systems: the roof, electrical, HVAC, and plumbing. This inspection is typically required by insurance companies to determine a property's insurability. Completing this form accurately is essential for homeowners seeking coverage.

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The 4 Point Inspection form serves as a critical tool in assessing the condition of key systems in a property, particularly for insurance purposes. This form requires detailed information about four essential components: the roof, electrical system, HVAC system, and plumbing. Each section prompts the inspector to provide specific data, including the age of the systems, any visible hazards, and the overall condition. For instance, the electrical section asks about the type of wiring and any remediation work completed, while the HVAC section inquires about the system's operational status and recent servicing. Additionally, the plumbing section addresses potential leaks and the condition of fixtures, and the roof section requires insights into the covering material and any signs of damage. Photographic evidence is also mandated to support the findings documented in the form. A licensed Florida inspector must complete, sign, and date the form, ensuring that the information is reliable and comprehensive. This inspection is not merely a formality; it plays a significant role in determining the insurability of a property, emphasizing the importance of accuracy and thoroughness in the reporting process.

Common mistakes

Incomplete Information: One common mistake is failing to fill out all required fields. Ensure that every section, including the insured/applicant name, application number, and address, is completely filled out. Missing information can lead to delays in processing your application.
Insufficient Photos: The inspection form requires specific photos for each system. Many people overlook this requirement, submitting forms without the necessary images. Remember to include photos of each side of the dwelling, all roof slopes, and key plumbing and electrical components.
Neglecting Hazards: When filling out the hazards section, some individuals may fail to report visible issues. It’s crucial to document any problems such as exposed wiring, leaks, or unsafe wiring. Ignoring these hazards can affect insurability and safety.
Incorrect Signatures: The form must be signed and dated by a Florida-licensed inspector. Submitting a form without the proper signature or with an inspector who is not licensed can lead to rejection of the application. Double-check that the inspector’s credentials are valid.
Inaccurate System Condition Reporting: It’s essential to accurately assess and report the condition of each system. Some people may mark a system as satisfactory without a thorough inspection. Misrepresenting the condition can lead to issues down the line, including claims denials.

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Key takeaways

When filling out and using the 4 Point Inspection form, consider the following key takeaways:

Complete Information: Ensure all sections of the form are filled out completely, including the insured/applicant name, application/policy number, and address inspected.
Photo Requirements: Include required photos for each system: the dwelling, roof, plumbing, and electrical systems. Each photo must meet the minimum requirements outlined in the form.
Licensed Inspector: A Florida-licensed inspector must complete, sign, and date the form. Only a licensed professional can certify the condition of the systems.
System Condition: Clearly indicate whether each system (roof, electrical, HVAC, plumbing) is in satisfactory or unsatisfactory condition, providing explanations as necessary.
Document Hazards: Note any hazards or deficiencies observed during the inspection. This includes issues like leaks, improper wiring, or HVAC problems.
Amperage Assessment: For electrical systems, assess whether the amperage is sufficient for current usage and provide explanations if it is not.
Supplemental Information: Provide additional details regarding the age and condition of the systems, including any updates or renovations that have been made.
Review Before Submission: Agents must review the completed form to ensure compliance with underwriting requirements before submitting it with an application for coverage.
Trade-Specific Signatures: Note that a trade-specific licensed professional can only sign off on the section relevant to their trade, such as an electrician for the electrical section.

4 Point Inspection 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
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
		Copper
_____	Completely re-piped	PVC/CPVC
		PVC/CPVC
_____	Partially re-piped	Galvanized
		Galvanized
(Provide year and extent of renovation in the comments below)		PEX
		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

Understanding 4 Point Inspection

What is a 4-Point Inspection Form?

The 4-Point Inspection Form is a document used to assess the condition of four critical systems in a property: the roof, electrical system, HVAC (heating, ventilation, and air conditioning), and plumbing. This inspection is particularly important for insurance purposes, as it helps determine the insurability of a property. A licensed inspector in Florida must complete and sign this form, ensuring that it meets the necessary standards for underwriting.

Why is a 4-Point Inspection necessary?

A 4-Point Inspection is often required by insurance companies, especially for older homes or properties with a history of maintenance issues. The inspection provides a comprehensive overview of the property's condition, helping insurers assess risks associated with insuring the home. By identifying any potential hazards or deficiencies, the inspection can also protect homeowners from unexpected repair costs in the future.

What are the minimum photo requirements for the inspection?

When submitting a 4-Point Inspection Form, it is essential to include specific photographs that document the condition of each system. The minimum photo requirements are as follows:

Each side of the dwelling
Each slope of the roof
Water heater, under-cabinet plumbing/drains, and exposed valves
Main electrical service panel with the interior door open
Electrical box with the panel off
All noted hazards or deficiencies

These photographs serve as visual evidence to support the inspector's findings.

Who can complete the 4-Point Inspection Form?

The inspection must be conducted by a verifiable Florida-licensed professional. This can include various types of professionals, such as general contractors, home inspectors, or building code inspectors. However, it is important to note that a trade-specific licensed professional can only sign off on the section of the form that pertains to their area of expertise. For example, an electrician may only certify the electrical section.

What happens if deficiencies are found during the inspection?

If the inspector identifies any deficiencies or hazards within the systems being evaluated, these must be documented in detail on the form. The inspector should provide comments regarding the nature of the issues, including any visible signs of damage or non-compliance with safety standards. This information is crucial for underwriting decisions, as properties with significant deficiencies may face challenges in obtaining insurance coverage.

How does the inspection affect insurance coverage?

The findings of the 4-Point Inspection directly influence an insurance company's decision regarding coverage. If the inspection reveals that any of the systems are not in good working order or if there are existing hazards, the insurance application may be denied or require additional conditions to be met before coverage is granted. Therefore, it is essential for homeowners to address any issues identified during the inspection to secure adequate insurance protection.

How to Use 4 Point Inspection

Completing the 4 Point Inspection form is an essential step in assessing the condition of a property. This process involves gathering detailed information about the roof, electrical system, HVAC, and plumbing. After filling out the form, it will be reviewed to ensure all necessary details are included for underwriting purposes.

Start with the Insured/Applicant Information: Fill in the name of the insured or applicant at the top of the form.
Application/Policy Number: Enter the relevant application or policy number next to the name.
Address Inspected: Provide the complete address of the property being inspected.
Year Built: Indicate the actual year the property was built.
Date Inspected: Write the date when the inspection was conducted.
Photo Requirements: Ensure that you have photos of each side of the dwelling, each slope of the roof, and specific plumbing and electrical components as noted in the requirements.
Electrical System Section: Complete details about the main and second panels, including type and total amps. Note any issues such as double taps or exposed wiring.
HVAC System Section: Indicate whether there is central AC and heat. Provide information about the system's working order and last servicing date.
Plumbing System Section: Answer questions regarding the water heater and any leaks. Comment on the condition of plumbing fixtures.
Roof Section: Describe the roof covering material, age, and condition. Note any visible damage or leaks.
Additional Comments/Observations: Use this section to provide any further details or observations that may be relevant to the inspection.
Inspector Information: The inspector must sign, date, and provide their license number and company name at the end of the form.

After completing the form, review all sections to ensure accuracy and completeness. Attach all required photos and submit the form to the appropriate parties for processing.