Monte Sereno, CA · Santa Clara County
Statement of Special Inspection Form
This form documents required special inspections and testing for a construction project and is completed by the owner or representative, design professional, contractor, and inspection agency.
What this form is
The form records project details, the special inspections and tests required, the agencies retained, and contractor responsibilities for specified construction systems. The owner or representative, on the advice of the registered design professional in responsible charge, must complete and obtain signatures from all parties and submit two copies to the Building Department for review and approval before a permit can be issued. A final report is required before a final can be issued.
Who needs it
The owner or representative, registered design professional, contractor, and special inspection agency complete or acknowledge sections for a project requiring special inspections.
How to submit it
Submit two completed copies to the Building Department for review and approval before a permit can be issued. The form lists the department address as 18041 Saratoga - Los Gatos Road, Monte Sereno, CA 95030.
About notarization
This document is signed and dated without a notary; the form requires acknowledgments and signatures but does not state that any attachment or related step must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the Statement of Special Inspection Form.
- 2
Complete Project Details
Enter the project title, plan check number, address, and required special inspection and testing information.
- 3
Gather Required Signatures
Complete the applicable sections and obtain signatures and dates from the parties identified on the form.
- 4
Submit Two Copies
Submit two copies to the Building Department for review and approval before a permit can be issued.
Frequently asked questions
- What does the Statement of Special Inspection Form document?
- It records project details, required special inspections and tests, retained inspection and testing agencies, and contractor responsibilities.
- Who completes the Statement of Special Inspection Form?
- The owner or representative completes the package on the advice of the registered design professional in responsible charge. The form also has acknowledgment sections for project parties.
- Do I need a notary for the Statement of Special Inspection Form?
- No. The form calls for signatures and dates but does not require notarization. It does not state that an attachment or related step must be notarized or sworn.
- How do I submit the Statement of Special Inspection Form?
- Submit two completed copies to the Building Department for review and approval before a permit can be issued. The form lists the department address in Monte Sereno.