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1 - General

Actual Year Built
1973
Address
Left side
Right side
Four Point Insurance Inspection

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.

This report contains the exact information that Form Insp4pt 01 18 requires. 

Front
Rear

A Four-Point Insurance Inspection is typically performed for a homeowner when requested by their insurance company to obtain a new insurance policy or renewing an existing policy. A Four-Point Insurance Inspection is far less in scope than a standard home inspection. This Four-Point Insurance Inspection is a limited, visual survey of the heating/air conditioning, roof, electrical, and plumbing systems. 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.

2 - Electrical System

Separate documentation of any aluminum wiring remediation must be provided and certified by a licensed electrician.
Main Type
Circuit breaker
Main Total Amps
150
Is amperage Sufficient for current usage?(Main)
Yes
Indicate presence of any of the following:
N/A
Hazards Present
N/A
General Condition of the Electrical system
Satisfactory
Main Panel age
Less than 1 year
Main Panel brand
Siemens
Wiring Type
Copper
Main Feed Wire Material
Multi-Strand Aluminum
Deficienies
Panel without cover
Main feed wires
Panel with cover
Panel Name
Branch wiring

3 - HVAC System

Central AC
Yes
Central Heat
Yes
HVAC systems in good working order?
Yes
Date of Last HVAC service or inspection:
Unknown
Wood-burning stove or central gas fireplace not professionally installed?
N/A
Space heater used as primary heat source?
No
Is the source portable?
No
Does the air handler/condensate line or drain pan show any signs of blockage or leakage, including water damage to the surrounding area?
No
Age of system
3 Years
Year last updated
2016
Deficienies
Package Unit
Package Unit Tag

4 - Plumbing System

Is there a temperature pressure relief valve on the water heater?
Yes
Is there any indication of an active leak?
No
Is there any indication of a prior leak?
No
Water Heater location
Garage
Dishwasher
Satisfactory
Refrigerator
Satisfactory
Washing Machine
Satisfactory
Water Heater
Satisfactory
Showers/Tubs
Satisfactory
Main shut off valve
Satisfactory
Sinks
Satisfactory
Sump Pump
N/A
Toilets
Satisfactory
All other visible
Satisfactory
Piping Supply system
Original to home
Type of pipes (Check all that apply)
Copper, PVC/CPVC
Piping Drain system
Not visible
Water Heater
Water heater connections
Running water-Kitchen sink
Below Kitchen sink
Water heater tag
Laundry connections
Toilet connections
Below bathroom sinks
Running water bathrooms
Main water shut off

5 - Roof

Covering Material
3-Tab
Roof Age
13
Remaining useful life (years)
10 years
Date of last roof permit
4/18/2005
Date of last update
Unknown
Any visible signs of leak Interior ceilings?
No
If updated(Check one)
Full replacement
Overall Condition
Satisfactory
Any visible signs of leaks?
No
Any visible signs of leak Attic/underside of decking?
No
Covering Material
Modified Bitumen
Roof Age
13
Remaining useful life (years)
4 years
Date of last roof permit
4/18/2005
Date of last update
Unknown
Any visible signs of leak Interior ceilings?
No
If updated(Check one)
Full replacement
Overall Condition
Satisfactory
Any Visible signs of damage/deterioration?(explain below)
N/A
Any visible signs of leaks?
No
Any visible signs of leak Attic/underside of decking?
No
Right slope
Other Elevations
Front Slope
Rear Slope

6 - Information

Inspector Name
Matthew Miller
Inspector Signature

Title
Inspector
License Number
HI11502
Date of Inspection
1/12/19
Company Name

Bless This Nest Inspections LLC

License Type
Home Inspector
Work Phone Number

954-593-0601