Mountain House, CA · San Joaquin County
Statement of Special Inspections
This project form identifies required special inspections, testing, and structural observations, and is completed for a construction permit project.
What this form is
The statement outlines the special inspections, testing, and structural observations applicable to a project. It identifies the owner, project address, permit number, responsible design professional, and inspection or testing providers, and includes schedules for selecting applicable inspections. The form also provides space for the owner’s authorization and building official approval. Complete it when special inspections or testing apply to the project.
Who needs it
Project owners and their registered design professionals complete this statement for construction projects requiring special inspections, testing, or structural observations.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the owner and responsible design professional sign and date it.
How to submit this form
- 1
Download The Form
Download the Statement of Special Inspections PDF for your project.
- 2
Complete Project Information
Enter the owner, project address, permit number, job description, and responsible design professional information.
- 3
Complete The Inspection Schedule
Identify applicable inspections and testing, and list the retained inspectors, testing agencies, and design professionals.
- 4
Gather Supporting Information
Include additional sheets as needed to identify inspection requirements; the form also refers to a steel appendix for certain inspections.
- 5
Submit To The City
Submit the completed statement to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Statement of Special Inspections cover?
- It outlines project-specific special inspections, testing, and structural observations, and identifies the inspectors, testing agencies, and design professionals retained for the work.
- Who completes this statement?
- The form identifies the owner, project, and responsible design professional, and provides spaces for the owner’s authorization and building official approval.
- Do I need a notary for the Statement of Special Inspections?
- No. This document is signed without a notary; the owner and responsible design professional sign and date it.
- How do I submit the Statement of Special Inspections?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Statement of Special Inspections doesn’t need a notary — but if you have another Mountain House form that does, a commissioned online notary can help.