Inspected )b y : Table of contents:
Andrew!Drath! !
Florida!Certified!Home!Inspector!
HI!#5741!
4=Point!Inspection!Page!1………..………..1!
4=Point!Inspection!Page!2…………….…….2!
Picture!Page!1……………………………………3!
Picture!Page!2……………………………………4!
Picture!Page!3……………………………………5!
4-Point Inspection
Personal Lines
(Edition 9/2012)
-
APPLICATION / POLICY #
INSURED/APPLICANT NAME
ADDRESS INSPECTED:
ACTUAL YEAR BUILT: DATE INSPECTED:
I
Minimum Photo Requirement:
Rear elevation
Front elevation
Open Main Electrical Panel and interior door
HVAC; heating systems equipment (with dated manufacturer's plate)
ALL hazards or deficiencies noted in this report.
A Florida Licensed inspector MUST complete, sign and date this form.
ELECTRICAL SYSTEM
(*SEPARATE DOCUMENTATION OF ANY ALUMINUM WIRING REMEDIATION MUST BE PROVIDED
AND CERTIFIED BY A LICENSED ELECTRICIAN)
Total Amps:
Year Last Updated:
Age of Main Panel:
I
I
Panel #2
Main Panel Amps
Wiring Type
Less
than 60 A Less than 60A Fuse
Romex, BX, or
Fuse
Conduit:
60A Fuse
60A Fuse
Active Knob & Tube
100A Fuse
or cloth wiring:
100A Fuse
100A CB
Aluminum*:
100A CB
200A CB:
Other (specify):
200A CB:
Other (specify):
Other (specify):
* If single strand (aluminum branch) wiring,
provide details of all remediation. Separate
documentation of all work must be provided
and certified by a licensed electrician.
Hazards Present
Over Fusing
Blowing Fuses or
Hazardous Panel
Breakers
Empty Breaker
Double Taps
Entire home rewired
Sockets
Exposed/Unsafe
with copper
Wiring
Loose Wiring
Connections repaired
Other (explain)
Improper
via COPALUM crimp
Grounding
Connections repaired
YesIs the electrical system in good working order? No (explain)
via AlumiConn
Use the Additional Comments/Observations Section below to provide
full
details of all updates, hazards, etc.
Central HVAC
Yes
No
Year Last Updated:
Age of System:
If not central,
indicate
primary
Hazards PresentAre the heating, ventilation and air
conditioning systems in good
working order?
heat source and fuel
Wood Burning Stove
type:
or central gas
Is the source
fireplace not
portable?
Yes
No
Yes
No
professionally
No (explain)
Yes
installed?
Space heater used
as primary heat
Yes
No
source?
Use the Additional Comments/Observations Section below to provide
full
details of all updates, hazards, etc.
- Insp4pt 09 12
Page 1
This form has been made available to verify the types, ages and conditions of a home's four major systems
HEATING SYSTEM
PHONE: (239) 770-4145
EMAIL: info@drathandassociates.com
4-Point Inspection
Personal Lines
(Edition 9/2012)
-
Deficiencies (check all that apply):
Year Last Updated:
Age of System:
Type of Pipes
Active leak
Is the plumbing system in good
working order?
Copper:
Indication of prior leak(s)
PVC:
Connections/Hoses leaking
Galvanized:
or cracked
No
Yes
Polybutylene:
Water Heater (explain)
Other (explain)
Other (specify):
Use the Additional Comments/Observations Section below to provide full details of all updates, hazards, deficiencies, etc.
Roof Useful
Predominant Roof
Age of Roof
Remaining Life:
Covering Material:
(years):
Date of Last Roofing
Date of Last
Permit:
Update:
Overall Condition of Roof:
Any visible signs of
If updated
damage/deterioration?
(check one):
Yes
No
Excellent
(e.g. curling/lifted/
Full Replacement
Good
loose/missing shingles
Partial
or tiles, sagging or
Fair
Replacement
uneven roof deck)
Poor (explain)
% of Replacement
Any signs of visible
Yes
No
leaks?
Use the Additional Comments/Observations Section below to provide full details of all updates, hazards, etc
.
ADDITIONAL COMMENTS OR OBSERVATIONS:
I
CERTIFY THAT
I
PERSONALLY INSPECTED THE PREMISES AT THE LOCATION ADDRESS LISTED ABOVE ON THE INSPECTION DATE NOTED.
I
CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT.
INSPECTOR SIGNATURE TITLE LICENSE NUMBER DATE
lnsp4pt 09 12
Page 2
PLUMBING SYSTEM
ROOF - WITH 2 ROOF PHOTOS, THIS PORTION CAN TAKE THE PLACE OF THE ROOF CONDITION CERTIFICATION FORM (CIT RCF-1)
This form has been made available to verify the types, ages and conditions of a home's four major systems
PHONE: (239) 770-4145
EMAIL: info@drathandassociates.com
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome