Property Inspection Report
Agency AA8685. Inspector Chris Swierczek
Requesting Agent
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Please Select
Maggie
Ted
Frank
Joe
Emily
Melissa
John
Insured Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Policy Number
*
Policy Effective Date
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Agent Notes
Inspection Date
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-
Month
-
Day
Year
Date
Was anyone present? If so, name?
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Property Type
*
Please Select
1 Family
2 family
3 Family
4 Family
Condo
Townhouse
Row Home (Center)
Row Home (End)
Commerical
Occupancy
*
Please Select
Owner Occupied
Tenant Occupied
Seasonal
Vacant
Back
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Exterior Conditions
Exterior Condtion
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Poor
1
2
3
4
Ok
5
1 is Poor, 5 is Ok
Exterior Building Material Types
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Frame
Alluminum Siding
Masonry
Vinyl Siding
Other
Peeling Paint
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None
Other
Chimney Condition
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Good
Other
Trees/Yard Concers
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None
Other
Deterioration/Dry Rot
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Good
Other
Roof
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Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Roof Type
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Comp Shingle
Metal
Slate/Tile
Wood
Flat
Other
Roof Condition/Attributes
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Shingles Worn
Missing Pieces
Patched
Moss Covered
Sagging
Snow Covered
Dormer Windows
Skylights
Other
Gutter/Downspounts
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Good
Other
Other Structures/Risks
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Other Structures/Risks Items
Pool
Shed
Pool House
Trampoline
Play Set
Other
Confirm Risk is protected (I.E. Locked Gate for pool, or netting for trampoline)
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Overall Condition
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Notes/Items of Concern
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Front of Home
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Rear of Home
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Other Structures/Risks Picture
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Area(s) of Concern Picture (If Applicaple)
Other Pictures
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