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4 Point Inspection Form

The 4-Point Inspection Form is a crucial document used primarily in Florida to assess the condition of a property's roof, electrical, HVAC, and plumbing systems. This inspection is typically required by insurance companies to evaluate a home’s insurability. By providing detailed information about these critical systems, the form helps ensure that potential hazards are identified and addressed before coverage is granted.

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4 Point Inspection 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

⇓ PDF File

Instructions on Utilizing 4 Point Inspection

Completing the 4 Point Inspection form requires careful attention to detail. Each section of the form must be filled out accurately to provide a comprehensive overview of the property's condition. Once the form is completed, it will serve as a critical document for determining the insurability of the property.

Begin by entering the Insured/Applicant Name at the top of the form.
Fill in the Application/Policy # next to the name.
Provide the Address Inspected, ensuring it is complete and accurate.
Indicate the Actual Year Built of the property.
Record the Date Inspected in the designated space.
Gather and attach the required photos, ensuring you have images of each side of the dwelling, each slope of the roof, and key plumbing and electrical components.
For the Electrical System section, indicate the type of main and second panel, total amps, and whether the amperage is sufficient for current usage. Note any hazards present.
In the HVAC System section, answer questions regarding central AC and heat, and provide the age of the system along with any signs of issues.
Complete the Plumbing System section by answering questions about leaks and the condition of plumbing fixtures. Note the age and type of piping.
For the Roof section, specify the predominant roof covering material, age, and remaining useful life. Document any visible damage or leaks.
Fill in any Additional Comments/Observations that are relevant, using additional pages if necessary.
Finally, ensure the form is signed and dated by a verifiable Florida-licensed inspector, including their title, license number, company name, license type, and work phone.

Misconceptions

Misconceptions about the 4 Point Inspection form can lead to confusion and misinterpretation of its purpose. Here are eight common misconceptions:

The 4 Point Inspection is a warranty for the property. Many believe that passing this inspection guarantees the property’s condition. In reality, it only assesses the current state of specific systems.
Any licensed inspector can complete the form. While a Florida-licensed inspector must complete the form, not all licensed professionals can sign off on every section. Each inspector is limited to their area of expertise.
The inspection is optional for insurance applications. This form is often required by insurance companies to evaluate the insurability of a property. Skipping it can result in denial of coverage.
The form guarantees no hazards exist. The inspection identifies visible hazards but does not guarantee that no issues are present. Hidden problems may still exist.
The inspection is only about the roof. The 4 Point Inspection assesses four major systems: roof, electrical, HVAC, and plumbing. Each component is crucial for determining overall property safety.
Photos are not necessary. The inspection requires specific photos to verify conditions. Failing to include these can lead to rejection of the form.
The form can be filled out by the homeowner. Only a licensed inspector can complete and sign the form. Homeowners do not have the authority to provide this certification.
It covers all aspects of home safety. The 4 Point Inspection focuses on specific systems and does not cover every safety aspect of the home. A more comprehensive home inspection may be necessary.

Understanding these misconceptions can help property owners and agents navigate the insurance process more effectively.

Documents used along the form

The 4-Point Inspection form is a crucial document used primarily in the insurance industry to assess the condition of a home’s key systems: the roof, electrical, HVAC, and plumbing. Alongside this form, several other documents may be required to provide a comprehensive view of the property's condition and ensure that all necessary information is available for underwriting decisions. Below is a list of related forms and documents commonly used in conjunction with the 4-Point Inspection form.

Roof Inspection Form: This form focuses specifically on the condition of the roof, detailing any damages, repairs, or maintenance performed. It complements the roof section of the 4-Point Inspection by providing a more in-depth analysis.
Electrical Inspection Report: A detailed report from a licensed electrician that assesses the electrical system's safety and functionality. It includes information about wiring types, panel conditions, and any hazards identified during the inspection.
HVAC Inspection Report: This document outlines the condition of heating, ventilation, and air conditioning systems. It includes details about the age of the system, maintenance history, and any issues that may affect performance.
Plumbing Inspection Report: A report that evaluates the plumbing system, including pipes, fixtures, and potential leaks. It provides insights into the system's age, materials used, and any repairs needed.
Hold Harmless Agreement Form: This legal document is essential for mitigating liability risks in various activities and can be found at nypdfforms.com/hold-harmless-agreement-form, ensuring participants understand their responsibilities.
General Home Inspection Report: A comprehensive inspection report that covers various aspects of the home, including structural integrity, safety issues, and overall condition. This document offers a broader view than the 4-Point Inspection.
Insurance Application: The application form submitted to the insurance company that includes personal information, property details, and coverage requests. It serves as the foundation for the underwriting process.
Disclosure Statements: These statements provide information about any known issues with the property, such as previous damage or repairs. They help ensure transparency during the underwriting process.
Maintenance Records: Documentation of any maintenance performed on the home’s systems. These records can support claims of good upkeep and may influence underwriting decisions.
Appraisal Report: An evaluation of the property’s market value conducted by a licensed appraiser. This report can be important for determining insurance coverage amounts.
Photo Documentation: Accompanying photographs that visually represent the condition of the home’s systems and any hazards noted. These images provide additional context for the information in the inspection forms.

These documents, when combined with the 4-Point Inspection form, create a thorough picture of a property's condition. They help insurers make informed decisions about coverage and ensure that homeowners are aware of their property's status. Proper documentation is essential for a smooth underwriting process and can significantly impact the outcome of an insurance application.