Fill Out Your Document

Fill Out a Valid 4 Point Inspection 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 inspection is typically required for homeowners seeking insurance coverage, as it helps determine the insurability of the property. To ensure a thorough evaluation, a Florida-licensed inspector must complete this form, providing detailed information and photographs of each system.

If you need to fill out the 4-Point Inspection Form, please click the button below.

Fill Out Your Document

Table of Contents

Form Overview

Fact Name	Description
Purpose	The 4-Point Inspection Form assesses the condition of four key systems: roof, electrical, HVAC, and plumbing.
Photo Requirements	Inspectors must provide photos of each side of the dwelling, each slope of the roof, and key plumbing and electrical components.
Inspector Credentials	A Florida-licensed inspector must complete and sign the form. Only licensed professionals can certify the condition of the systems.
Governing Law	Florida law mandates that the inspection must be performed by a licensed professional to determine insurability.
Condition Certification	The inspector must certify that each system is working as intended and note any visible hazards or deficiencies.
Agent Responsibility	Agents must review the completed form to ensure compliance with all requirements before submitting an application for coverage.

Download 4 Point Inspection PDF Form

Find Popular Templates

Girlfriend Applications - An introvert who appreciates quiet moments together.

Romantic Partner Application Form - Inspired by art, music, and the joy of creativity.

Dekalb County Water Application Online - Essential form for initiating residential water service.

Documents used along the form

The 4-Point Inspection Form is a crucial document for evaluating the insurability of a property. Along with this form, several other documents are commonly used to provide a comprehensive view of the property’s condition. Below is a list of these forms, each serving a specific purpose in the inspection and underwriting process.

Roof Inspection Form: This document details the condition of the roof, including materials, age, and any visible damage. It often includes photographs to support findings.
HVAC Inspection Report: This report assesses the heating, ventilation, and air conditioning systems. It provides information on the system's age, last service date, and any issues detected during inspection.
Plumbing Inspection Report: This document outlines the condition of the plumbing systems, including pipes, fixtures, and potential leaks. It is essential for identifying any plumbing-related hazards.
Electrical Inspection Report: This report focuses on the electrical system's safety and functionality. It includes details about the main panel, wiring type, and any hazards present.
General Home Inspection Report: A comprehensive overview of the property's condition, covering structural integrity, safety issues, and maintenance needs. This report may include findings from various specialized inspections.
Insurance Application: This form collects essential information about the property and the applicant. It is often submitted alongside the inspection forms for underwriting purposes.
Disclosure Statement: This document outlines any known issues or defects with the property. It is typically completed by the seller and helps inform the buyer and insurer of potential risks.
Photo Documentation: A collection of photographs taken during the inspection. These images are crucial for visual verification of the conditions noted in the inspection forms.

Each of these documents plays a vital role in ensuring a thorough assessment of the property. Together, they provide a clearer picture for both insurers and homeowners, facilitating informed decisions regarding coverage and necessary repairs.

Document Sample

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