06 - Addressing-Request-Form-2024 SIGNEDBuilding Development Center
3000 Pacific Ave SE, STE 100, Olympia, WA 98501
(360) 786-5490 / (360 754-2939 (Fax)
TDD Line (360) 754-2933
Addressing Email: tcaddressing@co.thurston.wa.us
www.thurstoncountybdc.com
ADDRESSING REQUEST FORM
(Please Use for Address Requests not Associated with a Permit)
DATE STAMP
Intake By: _____________________________
PROPERTY & PROJECT INFORMATION
1.Tax Parcel Number(s):
2.Subdivision Name (if known):Lot #:
3.Current Property Address (if applicable):
4.City:Zip Code:
5.Reason for Request (please attach additional pages if needed):
PROPERTY & PROJECT INFORMATION
6.How will this property be accessed? (Please provide the road/street name, and where the existing or
proposed driveway is located)
7.Is the access existing or proposed?
Existing
Proposed, but not yet built
I am hereby requesting a new or changed address. The information submitted is true, complete, and accurate to the best of my
knowledge and belief. I certify that I possess the authority to undertake the proposed activities. I hereby grant to the agen cies to
which this request is made or forwarded the right to enter the above-described location to inspection any proposed, in-progress or
completed work. I agree to start work only after all necessary permits/approvals have been received.
* DISCLAIMER
Building Development Center
Address Request Form
Page 2 of 2
PROPERTY OWNER INFORMATION (only fill out if you are NOT the Property Owner)
Do they prefer contact over phone or email? (If not selected, email will be the default)
Phone
Email
Name:
Phone: Cell:
Mailing Address:
City: State: Zip:
Email:
Signature*: Date:
REQUESTOR INFORMATION (your information)
Are you the owner of the above-referenced property?
Yes, I am the Owner.
No, I am NOT the Owner.
Do you prefer contact over phone or email? (If not selected, email will be the default)
Phone
Email
Name:
Phone: Cell:
Mailing Address:
City: State: Zip:
Email:
Signature*: Date:
If you are NOT the Property Owner, what is your relation to the Property Owner?
Revised May 2024