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Forms, Applications, & Reminder Lists

Plan Review & Construction

Application for New Project

Form Number: HCAI-FD-121

AB 2632 Project Building Permit  • Incremental Project Increment  • Plan Review  • Plan Review under Annual Building Permit  • SB1838 Project Building Permit  • Seismic Evaluation Report  • Compliance Plan Review  • NPC/SPC Upgrade

Project Application Information

Form Number: HCAI-FD-100

Adding or Supplanting Design Professionals • Adding or Supplanting Contacts

Building Permit

Form Number: HCAI-FD-302

Obtain a Building Permit

Notice of Start of Construction

Form Number: HCAI-FD-801

Notice of Start of Construction •  To be Submitted after Building Permit is Issued

Alternate Method of Compliance

Form Number: HCAI-FD-126

Alternate Method of Compliance • Must also submit HCAI-FD-100

Amended Construction Document

Form Number: HCAI-FD-125

Amended Construction Document • Must also submit HCAI-FD-100

Letter of Authorization (eCA Facility PIN)

Form Number: HCAI-FD-310

Obtain a new PIN • Change or Replace PIN holder 

Incremental Project Master

Form Number: HCAI-FD-127

Apply for Incremental Project Master

Incremental Project Increment

Form Number: HCAI-FD-121

Apply for Incremental Project Increment

Annual Building Permit

Form Number: HCAI-FD-306

Apply for Annual Building Permit

Project Cancellation/Withdrawal

Form Number: HCAI-FD-129

Cancel or Withdraw a Project • Application Fee Not Refundable 

Letter of Authorization (Agent for Legal Applicant)

Form Number: HCAI-FD-309

Designate an Agent for Legal Owner or Authorized Agent

Verified Compliance Report

Form Number: HCAI-FD-123 (Accessible version is available upon request)

Verified Compliance for Design Professionals of Record

Integrated Review

Form Number: HCAI-FD-122

Designate an Agent for Legal Owner or Authorized Agent

Application for Inspector of Record

Form Number: HCAI-FD-124

Inspector of Record

eChecklist – Fluoroscopy Equipment Replacement

Form Number: HCAI-FD-701

ePlan Review

Certificate of Inspection and Utility Connection Authorization

Form Number: HCAI-FD-385

Certificate of Inspection and Utility Connection

Fee Refund

Form Number: HCAI-FD-130

Fee Refund Request Form

Application for Unreasonable Hardship Exception to Accessibility Requirements (2010 CBSC or Prior)

Form Number: HCAI-FD-800 

2010 CBSC or prior year projects

Application for Unreasonable Hardship Exception to Accessibility Requirements (2013 CBSC)

Form Number: HCAI-FD-800-2013

2013 CBSC projects

Application for Unreasonable Hardship Exception to Accessibility Requirements (2016 CBSC)

Form Number: HCAI-FD-800-2016 

2016 CBSC Projects

Deferred Approval Submittal

Form Number: HCAI-FD-128

Deferred Submittal

Request for Excluded Work per FREER Manual

Form Number: HCAI-OSH-102

Excluded Work per FREER Manual

Non-Material Alteration Change Form

Form Number: HCAI-OSH-103

Non-Material Alteration (NMA) Changes

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Seismic Compliance

Application for Extension/Delay in Compliance

Form Number: HCAI-FD-384

General Acute Care Hospitals Only  • Revised 01/01/2019

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Other

Certification for Radiation Protection

Form Number: HCAI-FD-175

Radiation Protection

Methods of Procedure

Form Number: N/A

Memorandum for Methods of Procedure

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Testing, Inspection, and Observation (TIO) Program

Section 7-141, 2016 California Building Standards Code, requires the architect or engineer in responsible charge of a project to submit a Testing, Inspection and Observation (TIO) program to the Department of Health Care Access and Information (Department) for approval prior to issuance of a building permit. To assist the industry with preparation and implementation of the TIO program, the Department has developed the following resources:

OSHPD 1 Buildings

Testing, Inspection and Observation Program for OSHPD 1 projects (HCAI-FD-303A) (OSHPD 1 projects include all construction and remodel projects for general acute-care hospitals and acute psychiatric hospitals. OSHPD 1 projects also include construction and remodel of skilled nursing facilities and/or intermediate care facilities except those of single-story, Type V, wood or light steel-frame construction.)

OSHPD 2 Buildings

Testing, Inspection and Observation Program for OSHPD 2 projects (HCAI-FD-303B) (OSHPD 2 projects are limited to construction and remodel projects for skilled nursing facilities and/or intermediate care facilities of single-story, Type V, wood or light steel-frame construction.)

Instructions for preparing the TIO form

2022 Testing, Inspection, and Observation Form

To be used on projects submitted on or after January 1, 2023

2019 Testing, Inspection, and Observation Form

To be used on projects submitted on or after January 1, 2020

California Energy Code Forms

2016 Testing, Inspection, and Observation Form

To be used on projects submitted on or after January 1, 2017

2013 Testing, Inspection, and Observation Form

To be used on projects submitted on or after January 1, 2014

OSHPD 1 TIO Forms:

OSHPD 2 TIO Forms:

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Fire and Life Safety (FLS)

Forms

2022
2019

Reminder Lists

2022
2019

 For an accessible copy of any of the above documents, email regsunit@hcai.ca.gov.

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Plan Review Reminder Lists

California Building Standards Code (CBSC) 

eServices Reminder Lists 

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