What does the Sample Hold Harmless Letter do?

It records the property owner’s agreement to hold the City of Mesa harmless for claims connected with design, construction, and code-compliance review for the project.

What information does the letter ask for?

The owner fills in the date, project address, and building owner’s name, prints the letter on the property owner’s letterhead, and signs it.

Do I need a notary for the Sample Hold Harmless Letter?

No. This letter is signed and dated without a notary, and it does not identify any notarized or sworn attachment or related step.

How do I submit the Sample Hold Harmless Letter?

Address it to the Chief Building Official at the City of Mesa Development Services Department, PO Box 1466, Mesa, AZ 85211-1466.

Mesa, AZ · Maricopa County

No notary required

Sample Hold Harmless Letter

Property owners use this sample letter to agree to indemnify the City of Mesa for a building permit project under the self-certification program.

What this form is

This sample letter records a property owner’s agreement to protect, defend, indemnify, and hold the City of Mesa harmless in connection with design, construction, and code-compliance review. It is for a building permit issued under the Building Self-Certification Program. The owner places it on their letterhead, identifies the project address and owner, and signs and dates it; it also addresses correcting nonconforming construction at the owner’s expense.

Who needs it

A property owner seeking a building permit under the Building Self-Certification Program uses this letter for the project.

How to submit it

Address the letter to the Chief Building Official, City of Mesa Development Services Department, PO Box 1466, Mesa, AZ 85211-1466.

About notarization

This letter is signed and dated without a notary; the document does not identify any notarized or sworn attachment or related step.

How to submit this form

1
Download The Letter
Download the Sample Hold Harmless Letter PDF.
2
Complete The Letter
Print it on the property owner’s letterhead and enter the date, project address, and building owner’s name.
3
Sign And Date
Have the building owner sign and date the letter.
4
Send To The City
Address the letter to the Chief Building Official at the Development Services Department’s listed PO box.

Frequently asked questions

What does the Sample Hold Harmless Letter do?: It records the property owner’s agreement to hold the City of Mesa harmless for claims connected with design, construction, and code-compliance review for the project.
What information does the letter ask for?: The owner fills in the date, project address, and building owner’s name, prints the letter on the property owner’s letterhead, and signs it.
Do I need a notary for the Sample Hold Harmless Letter?: No. This letter is signed and dated without a notary, and it does not identify any notarized or sworn attachment or related step.
How do I submit the Sample Hold Harmless Letter?: Address it to the Chief Building Official at the City of Mesa Development Services Department, PO Box 1466, Mesa, AZ 85211-1466.

Need something notarized?

This Sample Hold Harmless Letter doesn’t need a notary — but if you have another Mesa form that does, a commissioned online notary can help.