Four-Point Insurance Inspection Report

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1 Four-Point Insurance Inspection Report Date of Inspection: Property address: Property's City, State, Zip Code: Approximate Total Square Feet: Approximate Total Living Area: Actual Year Built: Insured/Applicant Name: Application Policy Number: Inspector's Name: Inspector's License Number: Inspector's Signature: Inspector's Company Name: Inspector's Address: Inspector's City, State, Zip Code: Inspector's Address: Inspector's Phone Number: Thursday, October 10, 2013 Tampa, Florida James Booth HI877 Britannia Building Consultants, Inc. Post Office Box 867 Dunedin, Florida (727) Note: As from 09/01/12, a 4 point insurance inspection is required by Citizen s Insurance Company on every home 30 years or older in order to obtain a new insurance policy or renew an existing policy. A 4 point insurance inspection is limited to a visual inspection of the heating/air conditioning, roof, electrical and plumbing systems, but is far less in scope that a complete home inspection. ELECTRICAL SYSTEM (Separate Documentation of any Aluminum Wiring Remediation Must be Provided and Certified by a Licensed Electrician) Total System Amps: 200 amps Year Last Updated: 2008 Age of Main Panel: ~15 Main Panel Amps: 200 amps Main Panel Make: G.E. Sub-Panel(s) Amps: 200 amps Sub Panel Make(s): G.E. Wiring Type(s): Copper Hazards Present Blowing Fuses or Breakers: Empty Breaker Sockets: Loose Wiring: Improper Grounding: Over Fusing: Hazardous Panel: Double Taps: Exposed/Unsafe Wiring: Other (explained Below): 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. Entire home rewired with copper: Connections repaired via COPALUM crimp: Connections repaired via AlumiConn: Is the Electrical System in good working order? YES The system tested well and is coping with the needs of the home.

2 HEATING SYSTEM Age of System(s): 7 Year Last Updated: 2006 Hazards Present Wood Burning Space heater Stove or central used as primary gas fireplace not heat source? professionally installed? Yes No Yes No Central HVAC Yes No If not central, indicate primary heat source and fuel type: Source: Fuel Type: Is the source portable? N/A N/A Yes No Are HVAC systems in good working order? YES The system(s) tested to industry standards at the time of the inspection. PLUMBING SYSTEM Age of system: 87 Year Last Updated: 2008 Type of pipes: Deficiencies Active leaks: Connections/Hoses leaking Indication of prior leaks: or cracked: Other (see below): Water heaters: Ages: 5 & 7 yrs Is the plumbing system in good working order? YES Copper & galv. steel supplies PVC drains The system tested well and exhibited adequate volume and drainage at the time of the inspection. ROOF - With 2 roof photos this portion can take the place the ROOF CONDITION CERTIFICATION FORM (CIT RCF-1) Any visible Age of Roof: 7 Predominant Roof damage/ None Date of Last Update: 2006 Covering Material: Shingle deterioration? If updated (check one): Full Replacement Secondary Roof Covering Material: Secondary Roof Any signs of Shingle-g/apt visible leaks? Useful None Partial Replacement % of Replacement Covering Age: Date of Last 12+ Remaining Life: 13 Roofing Permit: 3/26/2006 Overall Condition of Roof: GOOD The roof inspected well and is free of any significant defects.

3 4 Point Inspection - Personal Lines Special Instructions A 4 Point Inspection is required for all homeowner, dwelling, and mobile home applications for properties over 30 years old. This 4-Point form includes the minimum data needed for Underwriting to properly evaluate a property application. While this specific form is not the Citizens generated report, the level of detail and information provided meets or exceeds Citizens' requirements and is built off of the official Citizens PHOTO REQUIREMENTS Photos must accompany each 4-Point inspection submitted to Citizens. The minimum photo requirement for all submissions is a front and rear elevation. However, there are additional photo requirements for a 4-Point inspection such as: Open Main Electrical Panel and Interior Door ALL hazards or deficiencies noted HVAC heating system (with dated manufacturer s plate) ROOF REQUIREMENTS The Citizens 4-Point inspection may be submitted in lieu of the Citizens Roof Condition Certification Form (CIT RCF-1) if a minimum of 2 photos of the roof are also provided. This will satisfy the required roof documentation listed in the Citizens Rules Manual. INSPECTOR REQUIREMENTS All inspections must be performed (and certified) by the appropriately Florida-licensed professional. Without a verifiable, certified inspector s dated signature, the documentation will not be accepted. The following FLORIDA-LICENSED individuals may complete a 4-Point Inspection for Citizens in its entirety: Note: A trade-specific, licensed professional may sign off only on their trade component of the 4-Point inspection form (e.g., a roofing inspector may sign off only on the roofing portion of the form). A general, residential, or building contractor A professional engineer A building code inspector A building code official who is authorized A registered architect by the State of Florida to verify building A home inspector code compliance CERTIFYING THE CONDITION OF EACH SYSTEM The Florida-licensed inspector is required to certify the condition of the electrical, HVAC and plumbing systems. Acceptable Condition means that each system is working as intended and there are no visible hazards or deficiencies. GENERAL COMMENTS / SYSTEM ISSUES This section of the 4-Point inspection must be completed with full details/descriptions if any of the following are noted on the inspection: Updates (provide full details of the types of updates Any hazards/deficiencies are present completed, date completed and by whom) Any system determined to be NOT in good working order. NOTE TO ALL AGENTS The writing agent must fully review each 4-Point inspection submitted with an application for coverage in advance. It is the agent s responsibility to ensure that all Citizens rules and requirements are met before the application is bound.

4 Front elevation Right side elevation Rear elevation Left side elevation

5 Roof front view Roof rear view Main electrical panel Electrical panel with cover

6 Condenser unit Condenser unit info plate Air handler Air handler info plate

7 Washing machine hoses Water heater Under kitchen sink Typical under sink view

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