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 Check 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 Infraction Speedy Trial Waiver AA LOG Form Agency Information Sheet Request for Court Records Form
Development Application	Development Application (2026)
How to Submit a Tip		Submit Online
Juror Response Form		Submit Online
Land Use Application Forms and Submittal Requirements	Accessory Dwelling Unit (2026) Affidavit of Agent Authority (2025) Affidavit of Ownership (2025) Code Amendment (2026) Code Compliance Matrix Tip Sheet (2024) Code Official Design Review (2026) Commerce on Public Property (2026) Comprehensive Plan Amendment (2025) Conditional Use Permit (2026) Critical Area Review 1 (2026) Critical Area Review 2 (2026) Critical Areas Tip Sheet - General Information (2023) Easement Modification / Extinguishment Application (2025) Long Subdivision - Final Approval (2026) Hearing Examiner Design Review Home Business Permit (2026) Lot Line Revision (2026) Modified Wireless Communication Facility - 6409 Eligible (2026) Modified Wireless Facility Non-6409 Eligible (2026) Noise Exception Request (2026) Long Subdivision - Preliminary Approval (2026) Plat Alteration and Vacation (2026) Public Agency Exception (2026) Reasonable Use Exception (2026) Reclassification of Property - Rezone (2026) SEPA Review (2026) Setback Deviation (2026) Sewer Lake Line Affidavit by Permit Applicant (2023) Shoreline Conditional Use Permit (SCUP) (2026) (Revision) Shoreline Conditional Use / Variance Permit (2026) Shoreline Exemption (2026) Shoreline Exemption Affidavit (2026) Shoreline Substantial Development Permit (2026) (Revision) Shoreline Substantial Development Permit (2026) Shoreline Variance (2026) Short Plat - Final Approval (2026) Short Plat - Preliminary Approval (2026) Short Subdivision - Final Approval (2025) Short Subdivision - Preliminary Approval (2025) Site Development Permit (2026) Site Development Worksheet - Single Family (2026) Small Wireless Facility (2026) Temporary Use Permit (2026) Transportation Concurrency Application (2023) Transportation Impact Analysis Guidelines (2023) Variance (2026)
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	2026-2027 RPD Restricted Parking Permit Application 2026 RPD Guest Permit Application 2026 RPD Temporary Contractor Permit Application Town Center & North Mercer RPD Map
Paws on Patrol Registration		Submit Online
Permit Application Forms	Permit Application Electrical Permit Application (2024) Fire Permit Application Mechanical and Plumbing Permit Application (2024) 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)
Pet First Aid Class Registration		Submit Online
Police Department Commendation / Complaint Form		Submit Online
Radar Certificates-Mercer Island	Kustom Falcon HRFH11576 LTI 2020 TRU SPEED S TJ000339 Kustom Pro Laser III PL 10383 Kustom Pro Laser III PL27458 Test Date 1/5/26 Kustom Pro Laser III PL27458 Test Date 1/19/25 Kustom Raptor RP1 RP29399 Kustom Raptor RP1 RP29447 Kustom Raptor RPI, RP29449 Tuning Fork 25744 Kustom Raptor RP1 RP29449 Tuning Fork 38725 Kustom Pro Laser III PL33121 Kustom Talon II TA02867 Kustom Talon II TA03822 Kustom Talon II TA04432 Tuning Fork 51886 Kustom Talon II TA04433 Tuning Fork 38725 Kustom Talon II TA04433 Tuning Fork 58283 Kustom Talon II TA04434 Kustom Talon II TA04435 Kustom Talon II TA04834 Tuning Fork 58283 Kustom Talon II TA04834 Tuning Fork 19844 Kustom Talon II TA05139 Kustom Talon II TA05402 Kustom Talon II TA05795 Tuning Fork 51883 Kustom Talon II TA05795 Tuning Fork 19844 Patrol Vehicle Speedometer Test
Radar Certificates-Newcastle	Kustom Talon T1207 Kustom Talon T1297 MPH BEE BEE664017644 BEE12220512 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 DB029549 Stalker DSR2X DP10366 - test date 2025 Stalker DSR2X DP10366 Stalker DSR2X DP016277 Stalker Dual DD016170 Stalker Dual DD016277 Stalker Dual DD016278 Stalker Dual SL DD006214 test date 2025 Stalker Dual SL DD006214 Stalker Dual 006214 Stalker Dual SL DD016262 Stalker Dual SL DD016278 Stalker Dual SL DD016170 Stalker Dual SL DD016283 Stalker EC008627 Stalker EC009028 Stalker EC009030 Stalker EC009032 Stalker II MDR AS016107 Stalker Lidar RLR LA005942 Test date 2024 Stalker Lidar RLR LA 005942 Stalker Lidar XLR LF007578 Stalker Lidar RLR LA007710 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 LTI 20/20 Tru Speed TJ000373 LTI 20/20 Tru Speed TJ010409 LTI 20/20 Tru Speed TJ008777 - test date 2024 LTI 20 20 Tru Speed TJ011816 LTI 20 20 Tru Speed TJ008777 LTI 20 20 Tru Speed TJ010404 LTI 20/20 Tru Speed TJ013170 Test date 2024 LTI 20 20 Tru Speed TJ013170
Recreational Outdoor Fire Permit		Submit Online
Residential Building Submittal Forms	Single Family Plan Coversheet (2024) Building Permit Application Intake Screening Request Form (2025) Construction Management Plan 2021 Energy Code - Single-family Prescriptive Worksheet 2021 Energy Code - Multifamily Prescriptive Worksheet 2018 Energy Code - Single-family Prescriptive Worksheet Fire Area and Valuation Form (2026) 2018 Energy Code - Multifamily Prescriptive Worksheet 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 2026 Application for Discounted Utility Rates
Utility Services	Leak Adjustment Request Form Payment Arrangement Application Account Authorization Form 2026 Utility Rates
Utility Tax