| Four-Point Insurance Inspection Report |
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| Date of Inspection |
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| Property's address: |
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| Property's City, Province, Postal Code |
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| Type of home: |
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| Type of construction: |
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| Type of foundation: |
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| Number of stories: |
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| Approximate square feet: |
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| Approximate total living area: |
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| Approxomate age of home: |
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| Client / Owner's name: |
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| Insurance company / Policy number: |
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| Inspector's name: |
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| InterNACHI ID number |
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| Inspector's Signature: |
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| Inspector's Company name: |
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| Inspector's address: |
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| Inspector's City, Province, Postal Code |
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| Inspector's email address: |
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| Inspector's phone number: |
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| Note: 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 covers far less in scope than a standard home |
| inspection. This Four-Point Insurance Inspection is a limited, visual survey of the heating, |
| air conditoning, roof, electrical and plumbing systems |
| Heating / Air Conditioning: |
| Types of heating systems: |
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| Estimated age of heating systems: |
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| Heating systems upgraded? Year? |
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| Condition of heating systems: |
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| Fuel tank located? |
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| Heating system comments: |
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| Types of cooling systems: |
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| Estimated age of cooling systems: |
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| Cooling Systems upgraded? |
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| Condition of cooling system: |
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| Cooling system comments: |
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| Plumbing: |
| Number of Bathrooms: |
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| Overall water pressure? |
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| Main supply line material: |
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| Main waste/vent material: |
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| Fixture supply line material: |
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| Fixture drain line material: |
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| Shut off valves present? |
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| Water heater location? |
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| Water heater fuel type? |
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| Approximate age of water heater? |
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| TPR valve present? |
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| Fire Sprinkler system present? |
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| Freeze hazards noticed? |
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| Polybutylene noticed? |
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| Plumbing leaks noticed? |
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| Recent plumbing upgrades? Year? |
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| Overall plumbing condition: |
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| Plumbing comments: |
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| Roof: |
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| Roof style: |
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| Type of roof covering: |
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| Estimated age of roof covering: |
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| Number of shingle layers: |
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| Type of sheathing: |
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| Flashing damage noticed: |
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| Missing shingles or covering? |
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| Truss or rafter damage noticed? |
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| Evidence of active leaks? |
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| Estimated life expectancy: |
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| Roof comments: |
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| Electrical: |
| Service amps: |
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| Size of service sufficient? |
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| Fuses or Circuit breakers? |
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| Main panel location: |
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| Panel ground observed? |
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| GFCIs present where required? |
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| AFCIs present in bedrooms |
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| Aluminum branch circuits? |
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| Active knob and tube wiring? |
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| Exposed or unsafe wiring noticed? |
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| Recent upgrades? Year? |
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| Overall electrical system condition: |
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| Electrical comments: |
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| Other Comments: |
| Are there any deficiencies which need correction? If so, explain. |
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| When will the deficiencies be |
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| corrected? Please provide an |
| approximate date of completion. |
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| Have all deficiencies been corrected? |
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| If so, when was this completed? |
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