4 Point Inspection Form – Fill Out and Use This PDF

The 4-Point Inspection Form is a critical tool used in the insurance industry, particularly in Florida, to assess the condition of a property's major systems: HVAC (Heating, Ventilation, and Air Conditioning), electrical, plumbing, and roof. Designed to provide underwriters with the information necessary to evaluate a property's insurability, this form must be completed by a verifiable Florida-licensed inspector. It scrutinizes not only the operational status but also highlights any visible hazards or deficiencies, ensuring properties meet specific safety and functionality standards. If you own a property in Florida and need to ensure it meets insurance requirements, consider filling out the 4-Point Inspection Form by clicking the button below.

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4 Point Inspection Form PDF Details

When it comes to buying, selling, or insuring a home in Florida, a 4-Point Inspection Form plays a crucial role in assessing the condition of a property's major systems. This thorough inspection covers the electrical system, HVAC (heating, ventilation, and air conditioning), plumbing, and roof, helping to identify any significant issues that could affect the home's insurability. The form, which must be filled out by a licensed Florida inspector, asks for detailed information about the age, condition, and any updates or hazards present in these key systems. Photos are also a critical component, providing visual evidence of the current state of the dwelling, from every side of the house and each roof slope to the main electrical panel and notable plumbing fixtures. Not only does the report inform underwriters, aiding their decision-making process regarding policy issuance, it also gives homeowners and potential buyers insights into maintenance needs or future investments. A unique aspect of this form is its focus on specific details such as the presence of potentially risky wiring types or plumbing materials, and the overall condition of the roof and HVAC system. Ultimately, the 4-Point Inspection Form is a tool designed to facilitate informed decisions in the real estate and insurance industries, ensuring that all parties are aware of the property's condition and any necessary repairs to guarantee safety and compliance with insurance standards.

Question	Answer
Form Name	4 Point Inspection Form
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	citizens 4 point form, 4 point form, form 4 point inspection, 4 point inspection form pdf

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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

How to Edit 4 Point Inspection Form Online for Free

You can certainly get forms applying our PDF editor. Changing the fillable 4 point inspection form form is not difficult if you keep up with these actions:

Step 1: At first, pick the orange "Get form now" button.

Step 2: You're now on the document editing page. You may edit, add information, highlight particular words or phrases, put crosses or checks, and insert images.

Fill out the fillable 4 point inspection form PDF by providing the text necessary for each individual section.

Jot down the details in Main Panel Type, Circuit breaker, Fuse, Total Amps, Second Panel Type, Circuit breaker, Fuse, Total Amps, Is amperage sufficient for current, Yes, No explain, Is amperage sufficient for current, Yes, No explain, and Indicate presence of any of the.

In the Supplemental information, Main Panel Panel age, Second Panel Panel age, Wiring Type Copper, Year last updated, Year last updated, NM BX or Conduit, BrandModel, BrandModel, and Sample Form Insppt box, describe the key data.

4 point inspection Supplemental information, Main Panel Panel age, Second Panel Panel age, Wiring Type Copper, Year last updated, Year last updated, NM BX or Conduit, BrandModel, BrandModel, and Sample Form Insppt fields to insert

Inside of box HVAC System, Central AC, Yes, Central heat, Yes, If not central heat indicate, Are the heating ventilation and, Yes, No explain, Date of last HVAC, Hazards Present, Woodburning stove or central gas, Yes, Space heater used as primary heat, and Yes, identify the rights and obligations.

part 4 to entering details in 4 point inspection

Complete the form by analyzing all these sections: Plumbing System, Is there a temperature pressure, Yes, Is there any indication of an, Yes, Is there any indication of a prior, Yes, Water heater location, General condition of the following, Satisfactory Unsatisfactory, Satisfactory Unsatisfactory, Dishwasher, Refrigerator, Washing machine, and Water heater.

Step 3: Choose the button "Done". The PDF document can be transferred. You will be able obtain it to your pc or send it by email.

Step 4: You may create duplicates of your form tostay clear of all of the potential future issues. You need not worry, we don't distribute or track your information.

4 Point Inspection Form – Fill Out and Use This PDF

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