Phoenix, AZ · Maricopa County
Care Facility Occupancy Certification
This form collects information about a proposed care facility for Phoenix Planning & Development to determine its building code occupancy classification.
What this form is
The form helps determine the appropriate building code occupancy group and whether a proposed care facility requires a change of occupancy and an approved automatic sprinkler system. It asks for facility, owner, and contact details; occupant and caregiver counts; services provided; custodial care information; and whether a government agency licenses or funds the facility.
Who needs it
Owners or representatives of proposed care facilities complete the form to provide information for Phoenix occupancy classification review.
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 form is signed and dated without a notary; the signer certifies the information is accurate, and no notarized attachment or sworn step is listed.
How to submit this form
- 1
Download The Form
Download the Care Facility Occupancy Certification PDF.
- 2
Complete Facility Details
Fill in the facility, owner, contact, occupancy, service, and custodial care information requested.
- 3
Sign And Date
Sign and date the certification that the information provided is accurate.
- 4
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 does the Care Facility Occupancy Certification determine?
- It provides information to determine the proposed facility’s building code occupancy group and whether a change of occupancy and approved automatic sprinkler system are required.
- What information does the form ask for?
- It asks about the facility, owner, on-site contact, occupant and caregiver counts, services, custodial care, and government agency licensing or funding.
- Do I need a notary for the Care Facility Occupancy Certification?
- No. The form calls for a signature and date and includes a certification that the information is accurate; it lists no notarized attachment or sworn step.
- How do I submit the Care Facility Occupancy Certification?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Care Facility Occupancy Certification doesn’t need a notary — but if you have another Phoenix form that does, a commissioned online notary can help.