Phoenix, AZ · Maricopa County
Self-Certification Program Hold-Harmless Letter
This sample letter lets a building owner agree to hold the City of Phoenix harmless for a project seeking a construction permit under the Self-Certification Program.
What this form is
Building owners use this sample letter when seeking a construction permit for a project under the Self-Certification Program. It asks the owner to identify the project and agree to protect and indemnify the city regarding design, construction, and code compliance review, and to correct nonconforming work at the owner’s expense.
Who needs it
A building owner seeking a construction permit for a project under the Self-Certification Program needs to provide this letter.
How to submit it
Print the letter on the property owner’s letterhead, address it to the Planning & Development Department at 200 W. Washington Street, Phoenix, AZ 85003, and sign it.
About notarization
This letter is signed without a notary; the sample requires the building owner’s signature and does not identify any notarized attachment or sworn step.
How to submit this form
- 1
Download The Letter
Download the Self-Certification Program Hold-Harmless Letter sample.
- 2
Complete Project Details
Enter the date, project name and address, and building owner’s name.
- 3
Print On Letterhead
Print the letter on the property owner’s letterhead, as the sample requires.
- 4
Sign And Address The Letter
Have the building owner sign it and address it to the Planning & Development Department at the listed Phoenix address.
Frequently asked questions
- Do I need a notary for the Hold-Harmless Letter?
- No. The sample requires the building owner’s signature, not a notary, and does not identify a notarized attachment or sworn step.
- How do I submit the Hold-Harmless Letter?
- Print it on the property owner’s letterhead, address it to the Planning & Development Department at 200 W. Washington Street, Phoenix, AZ 85003, and sign it.
- What does the building owner agree to?
- The owner agrees to protect and indemnify the city regarding the project’s design, construction, and code compliance review, and to remove or modify components that do not conform.
Need something notarized?
This Self-Certification Program Hold-Harmless Letter doesn’t need a notary — but if you have another Phoenix form that does, a commissioned online notary can help.