Cupertino, CA · Santa Clara County
Statement of Special Inspections, 2022 CBC
This form documents required special inspections and testing for a construction project and is completed by the project team and inspection agency.
What this form is
The Statement of Special Inspections identifies the project, retained inspection agencies, and required inspections and tests. The form says it is submitted to fulfill the stated CBC requirements and describes interim and final inspection reports, with the final report due before a Certificate of Use and Occupancy is issued. It also includes signature fields for the design professional, owner, inspection agency or inspector, and building official or designee.
Who needs it
Owners and project teams completing construction projects that require special inspections and testing use this form to document the inspection plan.
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 and dated without a notary; the owner, design professional, inspection agency or inspector, and building official or designee have signature fields.
How to submit this form
- 1
Download the Form
Download the Statement of Special Inspections PDF.
- 2
Complete the Project Details
Enter the site and project information, owner and contractor details, and the retained inspection agencies.
- 3
Complete the Inspection Schedule
Identify the applicable special inspections and tests in the schedule and complete the required signature and date fields.
- 4
Submit to the City
Submit the completed form 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 document?
- It identifies the project, retained inspection agencies, and the special inspections and tests required during construction, with signature fields for the relevant parties.
- Who completes the Statement of Special Inspections?
- The form includes information and signature fields for the owner, contractor, applicant, design professional, inspection agency or inspector, and building official or designee.
- Do I need a notary for the Statement of Special Inspections?
- No. This document is signed and dated without a notary; the owner, design professional, inspection agency or inspector, and building official or designee have signature fields.
- 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, 2022 CBC doesn’t need a notary — but if you have another Cupertino form that does, a commissioned online notary can help.