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Four-Point Insurance Inspection Report

Four-Point Insurance Inspection Report
Date of Inspection          
Property's address:          
Property's City, Province, Postal Code          
Type of home:          
Type of construction:          
Type of foundation:          
Number of stories:          
Approximate square feet:          
Approximate total living area:          
Approxomate age of home:          
Client / Owner's name:          
Insurance company / Policy number:          
Inspector's name:          
InterNACHI ID number          
Inspector's Signature:          
Inspector's Company name:          
Inspector's address:          
Inspector's City, Province, Postal Code          
Inspector's email address:          
Inspector's phone number:          
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:            
Estimated age of heating systems:          
Heating systems upgraded? Year?          
Condition of heating systems:            
Fuel tank located?            
Heating system comments:            
Types of cooling systems:            
Estimated age of cooling systems:          
Cooling Systems upgraded?            
Condition of cooling system:            
Cooling system comments:  
Number of Bathrooms:            
Overall water pressure?            
Main supply line material:            
Main waste/vent material:            
Fixture supply line material:            
Fixture drain line material:            
Shut off valves present?            
Water heater location?            
Water heater fuel type?            
Approximate age of water heater?          
TPR valve present?            
Fire Sprinkler system present?            
Freeze hazards noticed?            
Polybutylene noticed?            
Plumbing leaks noticed?            
Recent plumbing upgrades? Year?          
Overall plumbing condition:            
Plumbing comments:  
Roof style:          
Type of roof covering:          
Estimated age of roof covering:          
Number of shingle layers:          
Type of sheathing:          
Flashing damage noticed:          
Missing shingles or covering?          
Truss or rafter damage noticed?          
Evidence of active leaks?          
Estimated life expectancy:          
Roof comments:  
Service amps:          
Size of service sufficient?          
Fuses or Circuit breakers?          
Main panel location:          
Panel ground observed?          
GFCIs present where required?          
AFCIs present in bedrooms          
Aluminum branch circuits?          
Active knob and tube wiring?          
Exposed or unsafe wiring noticed?          
Recent upgrades? Year?          
Overall electrical system condition:          
Electrical comments:  
Other Comments:
Are there any deficiencies which need correction? If so, explain.  
When will the deficiencies be  
corrected? Please provide an
approximate date of completion.
Have all deficiencies been corrected?  
If so, when was this completed?
519-471-8888    London, ON
Sutton Preferred Realty Inc., Brokerage
Independently Owned and Operated
181 Commissioners Rd W
London ON
N6J 1X9
Copyright © 2007 Joyce Byrne Realtor
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