Forms, Permits, and Applications

Forms, Permits, and Applications Table
Title	Attachments	Submit Online
2019 Nonprofit Project Site Application		Submit Online
Accounts Payable	W-9 Form Lost Warrant Affidavit
Advisory Board or Commission Application Process		Submit Online
Alarm/Security Camera Registration		Submit Online
Appeals	Appeal Form
Attorney Forms	Petition for Deferred Prosecution Order Granting Deferred Prosecution
Business & Occupation Tax Information	Annual B&O Tax Form Quarterly B&O Tax Form
Code Compliance
Code Compliance Request Form		Submit Online
Community		Submit Online
Court Forms	Discovery Request - Submit a request for discovery Cuestionario de Preselección para Obtener Defensa Pública Public Defender Screening Form Community Service Hours Verification Form Hearing Request for Infraction Form Contested Hearing by Mail Form Mitigation Hearing by Mail Form School Bus Safety Program Affidavit of Non-Liability Request for Court Records Form Infraction Speedy Trial Waiver AA LOG Form Agency Information Sheet
Development Application	Development Application (2024)
Field Rental Request Form		Submit Online
How to Submit a Tip		Submit Online
Land Use Application Forms and Submittal Requirements	Accessory Dwelling Unit Permit Application (2024) Accessory Dwelling Unit (ADU) Affidavit (2023) Code Compliance Matrix Tip Sheet (2024) Conditional Use Permit Application (2023) Critical Area Review 1 (2024) Critical Area Review 2 (2024) Critical Areas Tip Sheet - General Information (2023) Design Review - Administrative (2023) Design Review - Design Commission (2023) Development Application Form - Required with all Land Use Applications (2024) Land Use Application Plan Set Guide (2023) Long Plat Final Approval Submittal Requirements (2023) Long Plat Preliminary Approval Submittal Requirements (2023) Lot Line Revision Submittal Requirements (2023) Noise Exception Request (2023) Plat Alteration and Vacation Submittal Requirements (2023) Reasonable Use Exception (2023) SEPA Checklist Submittal Requirements (2023) Setback Deviation Submittal Requirements (2023) Sewer Lake Line Affidavit by Permit Applicant (2023) Shoreline Conditional Use Permit Submittal Requirements (2023) Shoreline Exemption Affidavit (2023) Shoreline Exemption Submittal Requirements (2023) Shoreline Substantial Development Permit Submittal Requirements (2023) Short Plat Final Approval Submittal Requirements (2023) Short Plat Preliminary Approval Submittal Requirements (2024) Small Cell Facility Permit Submittal Requirements (2019) Temporary Use Permit Application (2024) Transportation Concurrency Application (2023) Transportation Impact Analysis Guidelines (2023) Variance Submittal Requirements (2023) Wireless Communications Facility - Eligible Facility Request Submittal Requirements (2023) Wireless Communications Facility - Submittal Requirements (2023)
Land Use Legislative Reviews	Code Amendments Submittal Requirements Rezone Submittal Requirements
Mercer Island Police IFIT-KC Non-Law Enforcement Community Representative Application		Submit Online
Parking Permits on Mercer Island	Map: Town Center and Restricted Parking District (RPD) 2025 RPD Restricted Parking Permit Application 2025 RPD Guest Permit Application 2025 RPD Temporary Contractor Permit Application
Paws on Patrol Registration		Submit Online
Permit Application Forms	Permit Application Electrical Permit Application (2024) Fire Permit Application Intake Screening Form Mechanical and Plumbing Permit Application (2024) Pre-Application Meeting Request Form Revision/Deferred Submittal Form Right of Way Use Permit Application (2024) Seasonal Development Limitation Waiver Side Sewer Permit Application Transportation Concurrency Form (2023) Tree Permit Application - Non-development (not related to construction) (2024)
Police Department Commendation / Complaint Form		Submit Online
Radar Certificates-Mercer Island	Kustom Falcon HRFH11576 Kustom Pro Laser III PL 10383 Kustom Pro Laser III PL 27458 Kustom Prol Laser III PL33121 Kustom Raptor RP1, RP29399 Kustom Raptor RP1, RP29447 Kustom Raptor RP1 RP29449 Kustom Talon II TA03822 Kustom Talon II TA04432 Kustom Talon II TA04433 Kustom Talon II TA04434 Kustom Talon II TA04435 Kustom Talon II TA04834 Kustom Talon II TA05139 Kustom Talon II TA05402 Kustom Talon II TA05795 LTI 2020 TRU SPEED S TJ000339 Patrol Vehicle Speedometer Test
Radar Certificates-Newcastle	Kustom Talon T1207 Kustom Talon T1297 LTI 20 20 Tru Speed TJ000373 LTI 20 20 Tru Speed TJ008777 LTI 20 20 Tru Speed TJ010404 LTI 2020 Tru Speed TJ010409 LTI 20 20 Tru Speed TJ011816 LTI 20 20 Tru Speed TJ013170 MPH Bee III BEE664017644 MPH BEE III BEE664017645 MPH BEE, BEE122201513 Pro Laser III PL 110383 Stalker AS016107 Stalker DD016262 Stalker DSR2X DB017299 Stalker DSR2X DP10366 Stalker Dual 006214 Stalker Dual DD016170 Stalker Dual DD016277 Stalker Dual DD016278 Stalker Dual SL DD006214 Stalker Dual SL DD016170 Stalker Dual SL DD016262 Stalker Dual SL DD016278 Stalker Dual SL DD016283 Stalker EC008627 Stalker EC009028 Stalker EC009030 Stalker EC009032 Stalker II MDR AS016107 Stalker Lidar RLR LA 005942 Stalker Lidar XLR LF007578 Applied Concepts Stalker Dual DE009034 Applied Concepts Stalker SDR II AS013796 Kustom Falcon FF12551 Kustom Falcon HR FH10076 Kustom Falcon HR FH10079 Kustom Golden Eagle XE07066 Kustom Pro Laser III PL10383 Kustom Pro Lite LP05391 Kustom Signals PRO Laser 4 LF14438
Recreational Outdoor Fire Permit		Submit Online
Residential Building Submittal Forms	Single Family Plan Coversheet (2024) Building Permit Application Intake Screening Request Form Construction Management Plan 2021 Energy Code - Single-family Prescriptive Worksheet 2021 Energy Code - Multifamily Prescriptive Worksheet 2018 Energy Code - Single-family Prescriptive Worksheet 2018 Energy Code - Multifamily Prescriptive Worksheet 2018 Energy Code Checklist Fire Area and Valuation Form Site Development Worksheet Small Projects Stormwater Site Plan / Report Tree Inventory and Replacement Submittal Information Transportation Concurrency Form (2023) Tree Submittal Checklist Water Meter Sizing Worksheet Seasonal Development Limitation Waiver Permit Extension and Renewal (2024)
Utilities Service Discounts	Application for Waived EMS 2024 Low Income Application
Utility Services	Leak Adjustment Policy and Request Form Utility Account Adjustment Policy 2024 Utility Rates
Utility Tax