Special Inspection Form PDF Details

In the realm of construction and safety, ensuring that buildings meet stringent codes and standards is paramount. The Special Inspection Form, alongside the Special Inspection and Testing Agreement, serves as a critical tool in this endeavor, especially within the jurisdiction of San Ramon, CA. This document, pivotal for both the City of San Ramon Building & Safety Services and project participants, outlines a detailed procedure for inspections and tests required by the California Building Code (CBC) Chapter 17. It implicates numerous stakeholders in the process, including property owners, contractors, architects, engineers, and specially designated inspectors. Their responsibilities range from acknowledging the need for special inspections, hiring City-approved inspection agencies, to adhering to the inspections schedule set forth by the document. The form meticulously details various types of inspections - from soil and steel construction to seismic resistance and spray fire-resistive materials, requiring specific acknowledgment from the involved parties before a construction permit is issued. Additionally, it sets forth guidelines for continuous onsite presence of inspectors, reporting of nonconforming items, and the eventual submission of a comprehensive final report asserting compliance. This form not only underscores the collaborative effort required to uphold building safety standards but also delineates the structured oversight necessary for complex construction projects, ensuring all work is executed to the highest degree of safety and integrity.

QuestionAnswer
Form NameSpecial Inspection Form
Form Length4 pages
Fillable?Yes
Fillable fields153
Avg. time to fill out31 min 40 sec
Other namesinspection form special, form inspection special, form san ramon, special inspection form

Form Preview Example

SPECIAL INSPECTION FORM and

Special Inspection and Testing Agreement

City of San Ramon

Building & Safety Services

2401 Crow Canyon Road, San Ramon, CA 94523

Office: (925) 973-2580 Fax (925) 838-2821

www.sanramon.ca.gov

Applicant/Tenant

Name:

Permit Number:

Job Site Address:

This document is used to clarify the information that is necessary for the Special Inspection Form and Special Inspection and Testing Agreement, contractor statement of responsibility, statement of special inspection and plans prepared by the engineer/architect-of-record, and City approved special inspectors.

The architect or engineer shall indicate on plans all materials, components, systems, and work required to have

special inspection or testing per CBC Chapter 17. The property owner or the registered design professional in responsible charge acting as the owner’s agent should hire the Special Inspection and Testing Agency from

the City approved special inspectors list.

Our preliminary review of your project located at the address listed above indicates one or more special inspections are required.

Read, complete, copy, and return 2 completed packets to the Building Department.

Should you have any questions, please telephone the Building Department at (925) 973-2580 for assistance.

ACKNOWLEDGEMENTS

I have read and agree to comply with the following terms and conditions as listed on the

“Special Inspection Testing Agreement”

Owner/Owner’s Agent:

Print

 

 

 

Signature:

Date:

Contractor:

Print

 

 

 

Signature:

Date:

Special Inspection/Agency:

Print

 

Agency Name:

Signature:

Date:

 

 

Project Engineer/Architect:

Print

 

 

 

Signature:

Date:

G:\Handouts and Documents\Master Word Files\Special Inspection Forms.doc

Page 1 of 4

09/27/13

”SPECIAL INSPECTION AND TESTING AGREEMENT”

CITY OF SAN RAMON

BUILDING AND SAFETY SERVICES

Alternate material/systems (CBC 1704.15)

Concrete (CBC 1704.4 and Table 1704.4)

Exterior insulation/finish systems (CBC

1704.14)

High- strength bolting (CBC Sec. 1704.3)

 

Masonry (CBC 1704.5)

 

Mastic and intumescent coating (CBC 1704.13)

Cast in place deep foundations (Pier

 

Foundations) (CBC 1704.9 and Table 1704.9)

 

Driven deep foundations (Pile Foundations)

 

(CBC 1704.8 and Table 1704.8)

Seismic resistance (CBC 1707 and 1708)

Soils (CBC 1704.7 and Table 1704.7)

Spray fire-resistive materials (CBC 1704.12)

Smoke-control system (CBC 1704.16)

Steel construction (CBC 1704.3 and Table

 

1704.3)

Structural Welding (CBC 1704.3.1)

Special cases

 

Wind resistance (CBC 1705.4)

 

Wood (CBC Sec. 1704.6)

The above list summarizes the types of special inspections and tests required. Special inspectors shall refer to the approved plans and specifications for the construction that requires special inspection.

BEFORE A PERMIT WILL BE ISSUED: The owner, engineer, architect of record or owner’s agent shall complete two (2) copies of this agreement. Including the attached structural tests and inspections schedule and the required acknowledgments. A pre-construction conference with all parties involved is required to review the special inspection requirements and procedures.

APPROVAL OF SPECIAL INSPECTON COMPANY/INSPECTORS: Each special inspection company/inspector shall be approved by the building department prior to performing any duties. Each company/inspector shall submit qualifications to the building department for review and approval and is subject to a interview for pre-qualification. Special inspectors shall display approved identification, as stipulated by the building department, when performing the function of special inspector on a job site.

Special inspection and testing shall meet the minimum requirements of C.B.C. Chapter 17, Section 1701.

The following conditions are also applicable:

A.Duties and Responsibilities of the Special Inspector

1.Observation of work. The special inspector shall observe the work for conformance with the building departments reviewed (stamped) design drawings and specifications and applicable workmanship provisions of the CBC, Architect/Engineer reviewed shop drawings and/or placing drawing may be used only as an aid to inspection. Special inspections are to be performed on a continuous basis, meaning that the special inspector is on site in the general area at all times observing the work required by special inspection. Periodic inspections, if any, must have prior approval by the building department based on a separate written plan reviewed and approved by the building department and the project engineer or architect.

2. Reporting nonconforming items. The special inspector shall bring nonconforming items to the immediate attention of the contractor and note all such items in the daily report. If any item is not resolved in a timely manor or is about to be incorporated in the work, the special inspector shall immediately notify the building department by telephone or in person, notify the engineer or architect, and post a discrepancy notice.

G:\Handouts and Documents\Master Word Files\Special Inspection Forms.doc

Page 2 of 4

09/27/13

3.Furnish daily reports. Each special inspector shall complete and sign both the special inspection record and the daily report form for each day's inspections to remain at the jobsite with the contractor for review by the building department's inspector.

4.Furnish weekly reports. The special inspector or inspection agency shall furnish weekly reports of tests and inspections directly to the building department, project engineer or architect, and others as designated. These reports must include the following:

Description of daily inspections and tests made with applicable locations; Test results;

Listing of all nonconforming items;

Reports on how nonconforming items were resolved or unresolved as applicable; and

Itemized changes authorized by the architect, engineer or building department if not included in the nonconforming items.

5.Furnish final report The special inspector or inspection agency shall submit a final signed report to the building department stating that all items requiring special inspection and testing were fulfilled and reported and, to the best of his/her knowledge, in conformance with the reviewed design drawings, specifications, approved change orders and the applicable workmanship provisions of the CBC. Items not in inspection coverage (i.e. missed inspections, periodic inspections when continuous was required, etc.) shall be specifically itemized in this report.

B.Contractor Responsibilities

1.Notify the special inspector. The contractor is responsible for notifying the special inspector or agency regarding individual inspections for items on the attached schedule and as noted on the building department reviewed plan. Adequate notice shall be provided so that the special inspector has time to become familiar with the project. Construction requiring continuous observation shall not proceed without the special inspector present to perform the required inspections.

2.Provide access to the approved plans. The contractor is responsible for providing the special inspector access to the reviewed plans at the jobsite.

3.Retain special inspection records. The contractor is also responsible for retaining, at the jobsite, all special inspection records submitted by the special inspector, and providing these records for review by the building department's inspector upon request.

C.The registered design professional responsibilities

1.Clearly indicate on plans all materials, components, systems, and work required to have special inspection or testing per CBC Chapter 17.

2.Specify type and extend of the special inspection and testing that is applicable to the project.

D.Building Department Responsibilities

1.Approve special inspection. The building department shall approve all special inspection companies and corresponding inspectors and special inspection requirements.

2.Monitor special inspection. Work requiring special inspection and the performance of special inspectors, shall be monitored by the building department’s inspector. The building department inspector’s

G:\Handouts and Documents\Master Word Files\Special Inspection Forms.doc

Page 3 of 4

09/27/13

approval shall be obtained prior to placement of concrete or other similar activities in addition to that of the special inspector.

CITY OF SAN RAMON

SPECIAL INSPECTIORS’ DAILY REPORT

Project Name:

 

Permit No:

Project Address:

 

 

Inspector’s Name:

 

 

Inspection type(s):

Continuous

Periodic

Describe inspection made, include locations:

List test made:

List items requiring correction, corrections of previously listed items, and previously listed uncorrected items:

List changes to approved plans authorized by Architect or Engineer.

Comments:

To the best of my knowledge, work inspected was in accordance with Building Department approved design drawings, specifications and applicable workmanship provisions of the California Building Code except as noted above.

Signed: _______________________________________________ Date: _________________

G:\Handouts and Documents\Master Word Files\Special Inspection Forms.doc

Page 4 of 4

09/27/13

How to Edit Special Inspection Form Online for Free

It is possible to work with special inspection form effectively in our PDFinity® online PDF tool. To keep our tool on the cutting edge of convenience, we strive to put into practice user-oriented features and enhancements on a regular basis. We are at all times thankful for any suggestions - play a pivotal role in revolutionizing PDF editing. All it takes is a few simple steps:

Step 1: Click on the "Get Form" button above on this webpage to open our editor.

Step 2: Using our advanced PDF editing tool, it's possible to accomplish more than simply fill in blank fields. Express yourself and make your forms look perfect with customized textual content put in, or adjust the file's original input to perfection - all that comes along with an ability to incorporate almost any graphics and sign the document off.

Filling out this document will require attentiveness. Make certain all necessary blanks are completed properly.

1. Fill out the special inspection form with a number of necessary fields. Note all of the required information and ensure there is nothing forgotten!

Filling in part 1 of special inspections form

Step 3: After proofreading the fields and details, press "Done" and you are all set! Join us today and instantly get access to special inspection form, all set for download. All changes made by you are preserved , enabling you to customize the file at a later stage if required. FormsPal guarantees safe form completion with no personal data recording or sharing. Rest assured that your information is in good hands with us!