Phoenix, AZ · Maricopa County
Self-Certification Program Professional of Record Statement
This statement is completed by professionals of record who certify project and plan information submitted to Phoenix for the Self-Certification Program.
What this form is
This statement records a professional of record’s certifications about permit application information and stamped plan pages submitted for a project. It is for use with Phoenix’s Self-Certification Program and asks for project details, professional information, signatures, dates, and professional seals. The document also includes design-team certification fields for listed disciplines.
Who needs it
Professionals of record and listed design-team members completing certifications for project plans submitted through Phoenix’s Self-Certification Program need this statement.
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 statement is signed and dated without a notary; the listed professionals are asked to affix their professional seals.
How to submit this form
- 1
Download The Statement
Download the Professional of Record Statement PDF.
- 2
Complete Project Details
Enter the professional of record, self-certification number, project number, and project address.
- 3
Complete Certifications
Complete the applicable professional and design-team certification fields, then sign and date them and affix the requested professional seals.
- 4
Submit To The City
Submit the statement to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Professional of Record Statement for?
- It records certifications about permit application information and stamped plan pages submitted for a project through Phoenix’s Self-Certification Program.
- Who completes this statement?
- The professional of record completes the statement, and the form also provides certification fields for listed design-team professionals.
- Do I need a notary for the Professional of Record Statement?
- No. The statement is signed and dated without a notary; the listed professionals are asked to affix their professional seals.
- How do I submit the Professional of Record Statement?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Self-Certification Program Professional of Record Statement doesn’t need a notary — but if you have another Phoenix form that does, a commissioned online notary can help.