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DevSvcs-TE-1.0-20160516
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Change of Address
Request Form
Building Services
Complete this form to submit at City Hall or send via email to COKAddress@kirklandwa.gov.
The following information is required in order for the GIS Division to review your request for a change of
address. Please assist us by ENTERING ALL INFORMATION REQUESTED. You will be notified within 5 business
days once the form has been submitted.
Property Owner's Name:
Mailing Address:
City:
State: Zip:
Phone Number:
Email:
Current Address:
New Address:
Reason for change:
Owner's Printed Name:
Owner's Signature:
Date:
If this request is approved, the owner is responsible for notifying the King County Treasurer, utility companies (personal
accounts for telephone, cable electrical, gas), voter and vehicle registrations, also the U.S. Postal Service, and fire or
burglar monitoring companies.
-------------- OFFICE USE ONLY --------------
GIS:
Approved Denied
Building Official / Fire Marshall:
Approved Denied
Old Address:
New Address:
Reason for change:
Parcel Tax Account #:
GIS Map/EnerGov changed by:
Date:
Correspondence sent by:
Date:
Notification sent to:
Finance Department
Planning & Building Department
Public Safety
Utility Companies
Public Works Department
U.S. Postal Service
King County E-911 / NORCOM
King County Dept. of Assessments
Waste Management
