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DS-320 (9-19)
FORM
DS-320
City of San Diego
Development Services
Inspection Oce
(858)492-5070
Application for Special
Inspector Registration
September 2019
New Application Renewal Application Add-On Classication
For new applications or applications to add special inspection categories, complete the entire form. For renewal applications, skip section
Name: Phone No. Email Address:
Address: City: State: Zip Code:
I DO DO NOT wish my phone number and email address stated herein to be published and made available to the public.
Indicate below the classication (s) of special inspection you are applying or renewing for:
Reinforced Concrete Pre-Stressed Concrete Pile Driving
Structural Masonry Structural Steel & Welding Spray-Applied Fire Proong
Structural Wood Exterior Insulations Finish Systems (EIFS)
I am currently registered as a special inspector in the following classication (s): ___________________________________
Qualifying Requirements—Attach documentation to verify minimum requirements as specied in Technical Bulletin BLDG-17-1.
Education & Other Construction Training: Attach copies of high school and college diplomas as well as any relevant transcripts. Include only
training or study from accredited programs.
Construction Experience: Attach a resume listing your work experience during the past 10 years that directly relates to the special inspection
category or categories for which you are applying to be registered with the City of San Diego.
Certication: Attach copies of required certicates or other documents showing the prerequisites in Technical Bulletin BLDG-17-1 have been
met.
I hereby certify that all of the information I have given herein and any documentation attached hereto is true
and complete to the best of my knowledge.
I understand that any false statements will subject me to disqualication.
__ ____________________________________________ ___________________________
Signature Required Date
FOR DEPARTMENT USE ONLY
B
A
C
C
D
City Registration
No.
Classication (s): Issued By: Date:
Date Check No. Receipt
No.
Received By Initial and Date
Application Fee
Paid
Registration Fee
Paid
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