Report number
Property Inspection Risk Assessment RCV Cost Replacement Value
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Inspector:
Client name
First name
Middle initial
Last name
Insurance agent/broker company name
Insurance agent/broker contact name
Insurance agent/broker phone
Please enter a valid phone number.
Date of Inspection
-
Month
-
Day
Year
Date
Square footage
Year Built:
Weather conditions
Hot
Warm
Cool
Sunny
Clear
Overcast
Foggy
Smoggy
Windy
Drizzle
Rainy
Damp
Dry
Building deficiencies:
Foundation deficiencies:
Primary roof minor deficiencies
Primary roof damage:
Secondary roof minor deficiencies
Secondary roof damage:
Heating deficiencies:
Cooling deficiencies:
Plumbing deficiencies:
Electrical hazards:
Primary special roof deduction
Primary special roof deduction
Primary special roof deduction score
Primary roof age
Primary 11 years to 20 years score
Primary 21+ years score
Primary roof age score
Secondary special roof deduction
Secondary special roof deduction
Secondary special roof deduction score
Secondary roof age
Secondary 11 years to 20 years score
Secondary 21+ years score
Secondary roof age score
Primary roof risk
Primary roof minor score
Primary roof damage score
Primary roof risk score
Secondary roof risk
Secondary roof minor score
Secondary roof damage score
Secondary Roof Risk Score
Heating risk
Drain pan/condensation score
Space heater score
Heater age 25 years to 30 years score
Heater age 31+ years score
Major heating deficiencies score
Heating Risk Score
Cooling risk
A/C age 20 years to 25 years score
A/C age 26+ years score
Major A/C deficiencies score
Cooling Risk Score
Plumbing risk
Unsatisfactory items score
High water pressure score
Water heater deficiencies score
Deteriorated/damaged hoses, pipes, drains score
Major plumbing deficiencies score
Plumbing Risk Score
Electrical risk
Melting/overheating/scorching in panel score
Sub panel in bathroom (considered unsafe) score
Knob and tube wiring score
Exposed/unsafe wiring score
Zinsco/Sylvania/Federal Pacific/Stab-Lok electrical panel score
Aluminum wiring score
Cloth sheathed wiring score
Loose/unsecure wiring score
Undersized wires to breaker(s) score
Not properly grounded / Improper grounding score
Improper electrical installation/materials score
Multiple splices in panel score
Double/multiple tapped/lugged breakers score
No GFCI's present score
Improperly fitting/improper brand breakers in panel score
Cable feed attachment loose at structure score
Wiring type Tinned/nickel clad copper score
Sub panel located in clothes closet, (possible hazard) score
Open breaker panel slot(s) score
Cable feed attachment doesn't have proper clearance score
Fuses / Blown fuses score
Fuses (instead of breakers) score
Panel located in clothes closet score
Main panel age 30 to 40 years risk score
Main panel age 41+ years risk score
Sub panel age 30 to 40 years risk score
Sub panel age 41+ years risk score
Electrical Risk Score
Electrical Risk Score
{number602}
{subPanel}
{subPanel604}
Electrical risk score contributors:
Back
Next
Insurance Information
Policy/Application Number
Insurance agent/broker company name
Insurance agent/broker contact name
Insurance broker/agent mobile phone number
Insurance broker/agent office phone number
Insurer
Please Select
AAA (Automobile Club of Southern California / CSAA Insurance Group)
Allstate
Amica Mutual Insurance Company
Auto-Owners Insurance
Bamboo Insurance
Chubb
Cincinnati Insurance
Farmers Insurance
GEICO
Liberty Mutual
Mercury Insurance
Nationwide
Progressive
Safeco
State Farm
Travelers
USAA
Client Information
Client name
First name
Middle initial
Last name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address County
Please Select
Los Angeles County
Orange County
Riverside County
San Bernardino County
San Diego County
Client phone number
Characteristics of the Risk
Inspection Date
-
Month
-
Day
Year
Date
Year Built:
Square footage:
Weather conditions
Hot
Warm
Cool
Sunny
Clear
Overcast
Foggy
Smoggy
Windy
Drizzle
Rainy
Damp
Dry
Stories/levels
Please Select
1
2
3
4
5
6
7
8
9
10
Dwelling
Building characteristics
Wood framed with stucco/siding/veneer
Wood framed with EIFS
Brick
Reinforced masonry block
Reinforced concrete/Monolithic
Other
Are there any major building deficiencies present?
Primary foundation type:
Slab
Unreinforced brick masonry
Basement
Stilts/Piers
Screw jacks/Jack stands
Crawlspace
Concrete
Reinforced masonry block CMU
Other
Unreinforced rock (river rock)
Wood construction
Other
Are there any major foundation deficiencies present?
Detached structures (if any):
None N/A
Pool/spa equipment/electrical
Above ground spa/electrical/equipment
BBQ area
Fire pit
Fireplace (outdoor)
Shed(s)
Tennis court
Play equipment
Lean-to type structure(s)
Patio(s) structure
Detached garage(s)
Shop building(s)
Pool house
Wash basin/sink (outdoor)
Kennel(s)
Horse stalls
Watering devices at animal pens
Sump pump(s)
Other
Survey / Minimum photo requirements
Required out structure photos (if any)
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
All sides of structure
Front photo
Left side of structure
Right side of structure
Rear side of structure
Section comments, concerns, recommendations
No comments
© 2025 Property Casualty Insurance Inspection
Back
Next
1.0 Roof
Required photos of all roof slopes
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Roof style/design
Hip
gable
Shed
Gambrel
Flat
Other
PRIMARY ROOF
Primary Roof History
Primary Roof History/Condition:
Unknown
Original (hasn't been replaced yet)
Full replacement
Partial replacement
Comments
Primary Roof % of replacement:
Please Select
Unknown
Original (hasn't been replaced yet)
25%
50%
75%
100%
Primary Roof age:
Please Select
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21 + years old
Primary Roof Remaining life:
Please Select
Unknown
1 remaining years
2 remaining years
3 remaining years
4 remaining years
5 remaining years
6 remaining years
7 remaining years
8 remaining years
9 remaining years
10 remaining years
11 remaining years
12 remaining years
13 remaining years
14 remaining years
15 remaining years
16 remaining years
17 remaining years
18 remaining years
19 remaining years
20 remaining years
21 remaining years
22 remaining years
23 remaining years
24 remaining years
25 remaining years
26 remaining years
27 remaining years
28 remaining years
29 remaining years
30 remaining years
31 remaining years
32 remaining years
33 remaining years
34 remaining years
35 remaining years
36 remaining years
37 remaining years
38 remaining years
39 remaining years
40 remaining years
41 remaining years
42 remaining years
43 remaining years
44 remaining years
45 remaining years
46 remaining years
47 remaining years
48 remaining years
49 remaining years
50 remaining years
51 remaining years
52 remaining years
53 remaining years
54 remaining years
55 remaining years
56 remaining years
57 remaining years
58 remaining years
59 remaining years
60 remaining years
Primary Roof Date of last permit/update:
Date
Primary roof material:
Asphalt shingles
Concrete tile
Tile
Clay/Spanish tile
Ceramic tile
Rolled materials
Gravel or rock over rolled materials
Asphalt shingles over wood shakes
Wood shingles
Wood shakes
Metal
Metal panels
Aluminum/copper or other form of metal
Cal Shake style roof
Monier style concrete tile roof, No underlayment or sheeting
Cement-fiber shingles
Foam
Plastic materials
Fiberglass
Slate
Solar tiles
Built-up materials with mineral surface finish
Built-up materials with gravel/rock surface
Modified bitumen (rolled roofing with coated surface)
Rubber EPDM (rolled materials with a rubber outer coating)
Other
Primary roof minor deficiencies (recommend maintenance):
Moderate granule loss
Missing/damaged/cracked shingles
Shingles are curling/lifting
Chipped/cracked tiles
Few broken/loose tiles
Dented metal tiles
Slight ponding evidence
Loose/wrinkled materials
Gravel sparse/missing
Exposed fasteners/nails
Trees/shrubs too close/touching
Moss growth
Flashings worn/weathered/rusted/bent/lifting
Flashing mastic is cracked/deteriorated
Flashing missing
Flashing rusted/deteriorated
Vent mastic cracked/deteriorated/missing
Vent cap(s) loose/missing
Vent(s) rusted/corroded
Gutters/downspouts bent/damaged
Gutters/downspouts loose at structure
Gutters clogged
Chimney flashing needs maintenance
Chimney cap cracked
Skylight/globes have hairline cracks
Other
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
PRIMARY ROOF DAMAGE/DEFICIENCIES
Primary roof deficiency/Roof damage:
Multiple broken/loose/damaged tiles
Soft spots in sheeting/decking
Exposed felt/plywood
Extensive granular loss
Monier style concrete tile roof, No underlayment or sheeting
Cal Shake style roof
Missing underlayment
Abnormal wavy areas/deflection/sagging
Damaged roof areas
Other
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
SECONDARY ROOF
Secondary Roof History
Secondary Roof History/Condition:
No secondary roof
Unknown
Full replacement
Partial replacement
Comments
Secondary Roof % of replacement:
Please Select
No secondary roof
Unknown
Original (hasn't been replaced yet)
25%
50%
75%
100%
Secondary Roof age:
Please Select
No secondary roof
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21+ years old
Secondary Roof Remaining life:
Please Select
No secondary roof
1 remaining years
2 remaining years
3 remaining years
4 remaining years
5 remaining years
6 remaining years
7 remaining years
8 remaining years
9 remaining years
10 remaining years
11 remaining years
12 remaining years
13 remaining years
14 remaining years
15 remaining years
16 remaining years
17 remaining years
18 remaining years
19 remaining years
20 remaining years
21 remaining years
22 remaining years
23 remaining years
24 remaining years
25 remaining years
26 remaining years
27 remaining years
28 remaining years
29 remaining years
30 remaining years
31 remaining years
32 remaining years
33 remaining years
34 remaining years
35 remaining years
36 remaining years
37 remaining years
38 remaining years
39 remaining years
40 remaining years
41 remaining years
42 remaining years
43 remaining years
44 remaining years
45 remaining years
46 remaining years
47 remaining years
48 remaining years
49 remaining years
50 remaining years
51 remaining years
52 remaining years
53 remaining years
54 remaining years
55 remaining years
56 remaining years
57 remaining years
58 remaining years
59 remaining years
60 remaining years
Secondary Roof Date of last permit/update:
Date
Secondary roof material:
No secondary roof
Asphalt shingles
Concrete tile
Tile
Clay/Spanish tile
Ceramic tile
Rolled materials
Gravel or rock over rolled materials
Asphalt shingles over wood shakes
Wood shingles
Wood shakes
Metal
Metal panels
Aluminum/copper or other form of metal
Cal Shake style roof
Monier style concrete tile roof, No underlayment or sheeting
Cement-fiber shingles
Foam
Plastic materials
Fiberglass
Slate
Solar tiles
Built-up materials with mineral surface finish
Built-up materials with gravel/rock surface
Modified bitumen (rolled roofing with coated surface)
Rubber EPDM (rolled materials with a rubber outer coating)
Other
Secondary roof minor deficiencies (recommend maintenance):
Moderate granule loss
Missing/damaged/cracked shingles
Shingles are curling/lifting
Chipped/cracked tiles
Few broken/loose tiles
Dented metal tiles
Slight ponding evidence
Loose/wrinkled materials
Gravel sparse/missing
Exposed fasteners/nails
Trees/shrubs too close/touching
Moss growth
Flashings worn/weathered/rusted/bent/lifting
Flashing mastic is cracked/deteriorated
Flashing missing
Flashing rusted/deteriorated
Vent mastic cracked/deteriorated/missing
Vent cap(s) loose/missing
Vent(s) rusted/corroded
Gutters/downspouts bent/damaged
Gutters/downspouts loose at structure
Gutters clogged
Chimney flashing needs maintenance
Chimney cap cracked
Skylight/globes have hairline cracks
Other
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
SECONDARY ROOF DAMAGE/DEFICIENCIES
Secondary roof deficiency/Roof damage:
Multiple broken/loose/damaged tiles
Soft spots in sheeting/decking
Exposed felt/plywood
Monier style concrete tile roof, No underlayment or sheeting
Cal Shake style roof
Extensive granular loss
Missing underlayment
Abnormal wavy areas/deflection/sagging
Damaged roof areas
Other
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Take Photo
Section comments, concerns, recommendations:
No comments
© 2025 Property Casualty Insurance Inspection
Back
Next
4.0 & 5.0 HVAC
4.0 Heating
Photo of heater with cover on
Photo of heater with cover off
Photo of heater data placard, if any (must be clear)
Take Photo
Take Photo
Take Photo
Condition of drain pan/condensation lines at heater (if any)?
Drain pan/condensation line Satisfactory
Drain pan/condensation line Unsatisfactory
Take Photo of heater drain pan (if any)
Take Photo of Condensation lines at heater (if any)
How many heating units unit(s):
None N/A
1 unit
2 units
3 units
4 units
5 units
6 units
7 units
8 units
9 units
10 units
Age of heating unit(s):
None N/A
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21 years old
22 years old
23 years old
24 years old
25 years old
26 years old
27 years old
28 years old
29 years old
30 years old
31+ years old
Thermostat controlled?
Yes
No
Type of heating units:
None N/A
Forced air furnace
Single sided gas wall heater
Gravity heater
Electric heat pump
Double sided gas wall heater
Hydronics
Dual pack
Single sided gas floor heater
Mini split
Double sided gas floor heater
Wall/Window Unit
Radiant heating
Other
Type of Heating Fuel:
None N/A
Gas
Propane
Solid fuel
Air vents & Ducting
Gravity
Electric
Boiler
Oil
Fan/Blower
Radiant
Other
Is there a fuel tank on premises?
Yes
No
If "yes" where is the tank located?
None N/A
Above ground
Below ground
Approximate age of tank:
Is there an annual service agreement/contract for HVAC?
Unknown
Yes
No
Is a solid fuel burning device being used on premises? (e.g. Wood burning stove, Fireplace)?
Yes
No
Is there a space heater of many type being used on premises?
Yes
No
Are there any major heating deficiencies?
Did not operate/heat/respond to thermostat commands
Premier or possible recall heater present
Gas heater located in a bedroom
Venting/combustion air issues
Unit unsafe to operate
Red-tagged by gas company
Missing heating unit(s)
Mold/microbial growth at base or enclosure
Other
5.0 Cooling
Photo of A/C unit, if any
Photo of A/C unit data placard if any, (must be clear)
Take Photo
Take Photo
Take Photo
Take Photo
How many cooling units unit(s)?
None N/A
1 unit
2 units
3 units
4 units
5 units
6 units
7 units
8 units
9 units
10 units
Age of cooling unit(s):
None N/A
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21 years old
22 years old
23 years old
24 years old
25 years old
26+ years old
Size (tons):
None N/A
1.5 Ton
2 Ton
2.5 Ton
3 Ton
3.5 Ton
4 Ton
5 Ton
6 Ton
7.5 Ton
10 Ton
Type of A/C system?
None N/A
Central
Dual pack
Evaporator cooler
Heat pump
Window/Wall unit
Other
Are there any major cooling deficiencies?
Did not operate/heat/respond to thermostat commands
Electrical or disconnect issues
Other
Section comments, concerns, recommendations:
No comments
© 2025 Property Casualty Insurance Inspection
Back
Next
6.0 Plumbing
Age of plumbing system?
Original to home
Completely re-piped
Partial re-pipe
Age of plumbing system (in years)
How many years ago was the plumbing fully re-piped?
Please Select
None N/A
repiped 1 year ago
repiped 2 years ago
repiped 3 years ago
repiped 4 years ago
repiped 5 years ago
repiped 6 years ago
repiped 7 years ago
repiped 8 years ago
repiped 9 years ago
repiped 10 years ago
repiped 11 years ago
repiped 12 years ago
repiped 13 years ago
repiped 14 years ago
repiped 15 years ago
repiped 16 years ago
repiped 17 years ago
repiped 18 years ago
repiped 19 years ago
repiped 20 years ago
repiped 21 years ago
repiped 22 years ago
repiped 23 years ago
repiped 24 years ago
repiped 25 years ago
repiped 26 years ago
repiped 27 years ago
repiped 28 years ago
repiped 29 years ago
repiped 30 years ago
repiped 31 years ago
repiped 32 years ago
repiped 33 years ago
repiped 34 years ago
repiped 35 years ago
repiped 36 years ago
repiped 37 years ago
repiped 38 years ago
repiped 39 years ago
repiped 40 years ago
repiped 41 years ago
repiped 42 years ago
repiped 43 years ago
repiped 44 years ago
repiped 45 years ago
repiped 46 years ago
repiped 47 years ago
repiped 48 years ago
repiped 49 years ago
repiped 50 years ago
repiped 51 years ago
repiped 52 years ago
repiped 53 years ago
repiped 54 years ago
repiped 55 years ago
repiped 56 years ago
repiped 57 years ago
repiped 58 years ago
repiped 59 years ago
repiped 60 years ago
repiped 61 years ago
repiped 62 years ago
repiped 63 years ago
repiped 64 years ago
repiped 65 years ago
repiped 66 years ago
repiped 67 years ago
repiped 68 years ago
repiped 69 years ago
repiped 70 years ago
repiped 71 years ago
repiped 72 years ago
repiped 73 years ago
repiped 74 years ago
repiped 75 years ago
repiped 76 years ago
repiped 77 years ago
repiped 78 years ago
repiped 79 years ago
repiped 80 years ago
repiped 81 years ago
repiped 82 years ago
repiped 83 years ago
repiped 84 years ago
repiped 85 years ago
repiped 86 years ago
repiped 87 years ago
repiped 88 years ago
repiped 89 years ago
repiped 90 years ago
repiped 91 years ago
repiped 92 years ago
repiped 93 years ago
repiped 94 years ago
repiped 95 years ago
repiped 96 years ago
repiped 97 years ago
repiped 98 years ago
repiped 99 years ago
repiped 100 years ago
How many years ago was the plumbing partially re-piped?
Please Select
None N/A
repiped 1 year ago
repiped 2 years ago
repiped 3 years ago
repiped 4 years ago
repiped 5 years ago
repiped 6 years ago
repiped 7 years ago
repiped 8 years ago
repiped 9 years ago
repiped 10 years ago
repiped 11 years ago
repiped 12 years ago
repiped 13 years ago
repiped 14 years ago
repiped 15 years ago
repiped 16 years ago
repiped 17 years ago
repiped 18 years ago
repiped 19 years ago
repiped 20 years ago
repiped 21 years ago
repiped 22 years ago
repiped 23 years ago
repiped 24 years ago
repiped 25 years ago
repiped 26 years ago
repiped 27 years ago
repiped 28 years ago
repiped 29 years ago
repiped 30 years ago
repiped 31 years ago
repiped 32 years ago
repiped 33 years ago
repiped 34 years ago
repiped 35 years ago
repiped 36 years ago
repiped 37 years ago
repiped 38 years ago
repiped 39 years ago
repiped 40 years ago
repiped 41 years ago
repiped 42 years ago
repiped 43 years ago
repiped 44 years ago
repiped 45 years ago
repiped 46 years ago
repiped 47 years ago
repiped 48 years ago
repiped 49 years ago
repiped 50 years ago
repiped 51 years ago
repiped 52 years ago
repiped 53 years ago
repiped 54 years ago
repiped 55 years ago
repiped 56 years ago
repiped 57 years ago
repiped 58 years ago
repiped 59 years ago
repiped 60 years ago
repiped 61 years ago
repiped 62 years ago
repiped 63 years ago
repiped 64 years ago
repiped 65 years ago
repiped 66 years ago
repiped 67 years ago
repiped 68 years ago
repiped 69 years ago
repiped 70 years ago
repiped 71 years ago
repiped 72 years ago
repiped 73 years ago
repiped 74 years ago
repiped 75 years ago
repiped 76 years ago
repiped 77 years ago
repiped 78 years ago
repiped 79 years ago
repiped 80 years ago
repiped 81 years ago
repiped 82 years ago
repiped 83 years ago
repiped 84 years ago
repiped 85 years ago
repiped 86 years ago
repiped 87 years ago
repiped 88 years ago
repiped 89 years ago
repiped 90 years ago
repiped 91 years ago
repiped 92 years ago
repiped 93 years ago
repiped 94 years ago
repiped 95 years ago
repiped 96 years ago
repiped 97 years ago
repiped 98 years ago
repiped 99 years ago
repiped 100 years ago
Type of plumbing material used:
Copper
PEX
Galvanized steel
PVC
CPVC
Polybutylene
Other
Photo of water heater, if any (must be clear)
Photo of water heater data placard, if any (must be clear)
Additional photo
Additional photo
Additional photo
Additional photo
Are there water heater deficiencies?
Water heater did not operate
Water heater(s) old/deteriorated/nearing end of useful life
Water heater(s) leaking
Water heater plumbing corroded
Water heater vent/combustion air issue(s)
Water heater seismic strapping issue
Other
General condition of the following:
Satisfactory items:
None N/A
Refrigerator
Washing machine
Dishwasher
Showers/Tubs
Toilets
Sinks
Water main shut-off
Other
Unsatisfactory items:
No unsatisfactory conditions
Refrigerator
Washing machine
Dishwasher
Showers/Tubs
Toilets
Sinks
Water main shut-off
Other
Is there a water shut-off valve present?
Could not locate
Yes
No
Other
Take Photo shut-off valve
Is there a water pressure regulator present?
Could not locate
Yes
No
Other
Water pressure regulator (if any)
Is the owner/resident aware of the shut-off valve and location?
None N/A
Unknown
Yes
No
Other
Is there a smart water shut-off valve or a whole-house leak detection and automatic shutoff system?
Unknown
Yes
No
Other
Take Photo of water pressure
Water pressure normal range:
Water pressure 45 psi normal low
Water pressure 50 psi normal
Water pressure 55 psi normal
Water pressure 60 psi normal
Water pressure 65 psi normal
Water pressure 70 psi normal
Water pressure 75 psi normal
Water pressure 80 psi normal
Water pressure 85 psi normal
Water pressure 90 psi normal high
Water pressure 95 psi normal high
Water pressure high range:
Water pressure 100 psi (high)
Water pressure 105 psi (high)
Water pressure 110 psi (extremely high)
Water pressure 115 psi (extremely high)
Water pressure 110 psi (extremely high)
Water pressure 120 psi or more (extremely high)
Are there any deteriorated or damaged hoses, pipes or drains present?
Deteriorated or damaged hoses, pipes or drains
No
Take Photo of plumbing under sinks
Take Photo of plumbing under sinks
Take Photo of plumbing under sinks
Take Photo of plumbing under sinks
Take Photo of plumbing under sinks
Take Photo of plumbing under sinks
Is there a sump pump on the property?
Yes
No
Other
If a sump pump is present, is it operational?
None N/A
Yes
No
Other
Is there a septic system on the property?
Unknown
Yes
No
Other
If there is a septic system, provide comments and concerns
None N/A
Are there any major plumbing deficiencies?
Supply line leak(s)
Corroded piping
Galvanized piping
Polybutylene
Waste line leaks
Corrosion/cysts at cast iron/metal drain/waste lines
Fuel gas piping rusted/corroded/improperly installed
Other
© 2025 Property Casualty Insurance Inspection
Section comments, concerns, recommendations:
No comments
Back
Next
7.0 Electrical
Main electric panel
Take a Photo of the main panel with the dead front cover on
Take a Photo of the main panel with the dead front cover off
Age of main panel:
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21 years old
22 years old
23 years old
24 years old
25 years old
26 years old
27 years old
28 years old
29 years old
30 years old
31 years old
32 years old
33 years old
34 years old
35 years old
36 years old
37 years old
38 years old
39 years old
40 years old
41+ years old
Main panel location(s):
North side of the structure
South side of the structure
East side of the structure
West side of the structure
Exterior wall
Common Area/closet - North
Common Area/closet - South
Common Area/closet - East
Common Area/closet - West
Common Area/closet - locked - not inspected
Common area - Subterranean parking structure
Could not identify unit (multiple meters present with no unit labels), consult the seller for meter location
Could not locate - not inspected - consult seller for location
Panel is locked - not inspected
Other
Main panel manufacturers (select all that apply):
None N/A
Unknown/not legible
Square D
Eaton
Siemens
ABB
Leviton
General Electric
Legrand
Mitsubishi Electric
Rockwell Automation
IndustLabs
Penn Panel
Panel-Fab
E-Abel
M-Tech Control
Panel Control, Inc. (PCI)
Paneltronics
EBI Electric
Control Panels USA
OEMPANELS
Panelmatic
South Coast Controls
KDM
Guangdong Yuqui (CNTCE) Intelligent Technology
Yuanki Electric
Fujian Guozhiyun Information Technology Co., Ltd.
Changhe Enclosures
Bay Power
Guangpu Electrical Company
State Manufacturing Corporation
Zhejiang Zhegui Electric Co., Ltd.
Huayi Electric
Intelligent Lighting Controls, Inc.
LA Marche MFG
Multi-Craft Contractors
Omni Control Technology, Inc.
Hotset America Corporation
Avatar Instruments
E+i Engineering USA Corp
Federal Pacific Electric panel
Zinsco panel
Sylvania panel
Challenger
Pushmatic panel
Wadsworth Electric Manufacturing Company
ITE
Bryant
Crouse-Hinds
Murray
Stab lock panel
Other
Main panel amps:
Unknown/not legible
30 amps
40 amps
50 amps
60 amps
70 amps
90 amps
100 amps
125 amps
150 amps
175 amps
200 amps
225 amps
250 amps
400 amps
800 amps
Other
Main panel amps per label:
Unknown/Not legible
30 amps
40 amps
50 amps
60 amps
70 amps
90 amps
100 amps
125 amps
150 amps
175 amps
200 amps
225 amps
250 amps
400 amps
800 amps
Other
Sub electric panel(s)
Take a Photo of the sub panel with dead front cover on
Take a Photo of the sub panel with dead front cover of
Age of sub panel(s):
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21 years old
22 years old
23 years old
24 years old
25 years old
26 years old
27 years old
28 years old
29 years old
30 years old
31 years old
32 years old
33 years old
34 years old
35 years old
36 years old
37 years old
38 years old
39 years old
40 years old
41+ years old
Sub panel location(s)?
Near main panel
Garage
ADU
Exterior wall
Interior wall
Hall area wall
Bedroom wall
Laundry wall
Kitchen wall
Clothes closet, (possible hazard) recommend a licensed electrician to evaluate
Detached Shop
Guest house
Second floor main hallway
Basement
Storage area
Pool equipment area
Pool equipment area (cover not removed)
Out structure
Could not locate - not inspected
Panel cover is locked - could not inspect
Other
Sub panel manufacturers (select all that apply):
Unknown/not legible
Square D
Eaton
Siemens
ABB
Leviton
General Electric
Legrand
Mitsubishi Electric
Rockwell Automation
IndustLabs
Penn Panel
Panel-Fab
E-Abel
M-Tech Control
Panel Control, Inc. (PCI)
Paneltronics
EBI Electric
Control Panels USA
OEMPANELS
Panelmatic
South Coast Controls
KDM
Guangdong Yuqui (CNTCE) Intelligent Technology
Yuanki Electric
Fujian Guozhiyun Information Technology Co., Ltd.
Changhe Enclosures
Bay Power
Guangpu Electrical Company
State Manufacturing Corporation
Zhejiang Zhegui Electric Co., Ltd.
Huayi Electric
Intelligent Lighting Controls, Inc.
LA Marche MFG
Multi-Craft Contractors
Omni Control Technology, Inc.
Hotset America Corporation
Avatar Instruments
E+i Engineering USA Corp
Federal Pacific Sub panel
Zinsco Sub panel
Sylvania Sub panel
Challenger
Pushmatic Sub panel
Wadsworth Electric Manufacturing Company
ITE
Bryant
Crouse-Hinds
Murray
Stab lock panel
Other
Sub panel amps:
Unknown/not legible
30 amps
40 amps
50 amps
60 amps
70 amps
90 amps
100 amps
125 amps
150 amps
175 amps
200 amps
225 amps
250 amps
400 amps
Sub panel amps per label:
Unknown/not legible
30 amps
40 amps
50 amps
60 amps
70 amps
90 amps
100 amps
125 amps
150 amps
175 amps
200 amps
225 amps
250 amps
400 amps
If any of the panels above were updated, what was the extent of the update?
No update/replacement
Partial replacement
Full replacement
Other
Circuit breakers or fuses?
Circuit breakers
Fuses
If any wiring has been updated, what was the extent of the update?
No update/replacement
Partial replacement
Full replacement
Other
Is the electrical system properly grounded?
Yes
No
Partial
Are GFCI's present in wet areas; (bathrooms, kitchen, laundry, garage, exterior)?
Yes
No
Partial
Other
GFCI location(s) (select all that apply):
None N/A
Exterior wall outlets
Garage
Bathrooms
Kitchen
Laundry
Electric panel
Other
Wiring types used in structure, out structures, exterior and grounds:
Copper
copper and multi-strand/heavy gauge aluminum at 240-Volt circuits
Armored Cable, (also known as AC or BX cable), metallic sheathed
Tinned/nickel clad copper
Aluminum wiring
Wiring method(s) used in structure, out structures, exterior and grounds:
Non-metallic sheathed cable (romex)
Flexible conduit
Solid conduit/tubing
Casing and capping
Cloth sheathed wiring
Knob and tube wiring
High to Catastrophic Risk (if any):
Loose/unsecure wiring
Exposed/unsafe wiring
Improper grounding
Aluminum wiring
Knob and tube wiring
Multiple splices in panel (not exceed 40% of the cross-sectional area of that space)
Melting/overheating/scorching in panel
Zinsco/Sylvania/Federal Pacific/Stab-Lok electrical panel
Double/multiple tapped/lugged breakers
Open breaker panel slot(s) at panel box cover
Undersized wires to breaker(s)
Improperly fitting/improper brand breakers in panel
Blown fuses
Cable feed attachment loose at structure
Cable feed attachment doesn't have proper clearance
Improper electrical installation/materials
Bathroom (considered unsafe)
Take Photo Hazards
Take Photo Hazards
Take Photo Hazards
Take Photo Hazards
Take Photo Hazards
Take Photo Hazards
Section comments, concerns, recommendations:
No comments
© 2025 Property Casualty Insurance Inspection
Back
Next
Qualifications/Fraud Statement/Signature
Eligible Inspectors:
Only a California General building contractor firm or Municipal building inspector can fill out this form
I certify that the above statements are true and correct
Property Inspector
California General contractors license #579473
Submit
Should be Empty: