Cupertino, CA · Santa Clara County
Statement of Special Inspections, 2019 CBC
This statement documents planned special inspections and testing for a construction project and is completed by the project team and owner.
What this form is
The form is submitted to fulfill the stated special inspection requirements for a construction project. It asks for site and project details, owner and project team information, retained inspection agencies, and a schedule of required inspections and tests. The project engineer or architect, owner, inspection agency or inspector, and building official or designee have signature and date lines.
Who needs it
Owners and project teams completing a construction project that requires the special inspections and testing described in the statement need this form.
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 listed signers just sign and date it.
How to submit this form
- 1
Download the Form
Download the Statement of Special Inspections PDF.
- 2
Complete Project Information
Enter the site, project, owner, contractor, applicant, and design professional information requested.
- 3
List Agencies and Inspections
Identify the retained inspection agencies and complete the schedule of special inspections and testing.
- 4
Sign and Submit
Have the listed parties sign and date the statement, then submit it to the city department named on the form.
Frequently asked questions
- What is the Statement of Special Inspections used for?
- It documents the special inspections and tests for a construction project, including the retained inspection agencies and the schedule of required inspections.
- Who signs the statement?
- The form includes signature and date lines for the project engineer or architect, owner, 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 without a notary; the listed signers just 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, 2019 CBC doesn’t need a notary — but if you have another Cupertino form that does, a commissioned online notary can help.