Cupertino, CA · Santa Clara County
Statement of Special Inspections
Cupertino property owners or their agents complete this form to identify project inspections and testing and obtain signatures from the parties involved.
What this form is
The form identifies project portions requiring special inspection and testing and outlines responsibilities for the owner, contractor, and inspection or testing agency. The property owner or agent, advised by the registered design professional in charge, completes it and secures signatures from all parties. It collects project and contact details, agency information, inspection categories, and acknowledgements; the form says the final inspection report is required before a Certificate of Use and Occupancy is issued.
Who needs it
A property owner or owner’s agent completes the form for a project requiring special inspections, on advice from the registered design professional in charge.
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 signer and other listed parties sign and date the form, with no notarized or sworn attachment specified.
How to submit this form
- 1
Download the Form
Download the Statement of Special Inspections PDF.
- 2
Complete Project Details
Enter the site, owner, contractor, applicant, design professional, and project information.
- 3
List Inspection Agencies
Provide the firm and contact information for the inspection and testing agencies to be retained.
- 4
Gather Signatures
Secure signatures and dates from the parties listed on the form.
- 5
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Statement of Special Inspections?
- It identifies project portions requiring special inspection and testing and outlines responsibilities for the owner, contractor, and inspection or testing agency.
- Who completes this form?
- The property owner or owner’s agent completes it on the advice of the registered design professional in charge and secures signatures from all parties.
- Do I need a notary for the Statement of Special Inspections?
- No. The form is signed and dated by the listed parties without a notary; it does not specify a notarized or sworn attachment.
- 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 Cupertino form that does, a commissioned online notary can help.