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Application For Class 11 Permit LIC 391 - Washington
| Application For Class 11 Permit Form. This is a Washington form and can be used in Applications Liquor Control Board Statewide . |
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For Office Use Only Licensing and Regulation PO Box 43085 Olympia WA 98504-0385 www.liq.wa.gov Date Check No. Amount Rec'd Rec'd by Application for Class 11 Permit Bed and Breakfast Facility - $75 Fee A class 11 permit allows a bed and breakfast lodging facility to donate or serve beer or wine without charge to overnight guests, for consumption on the premises. A bed and breakfast lodging facility is defined as a hotel or similar facility, offering from one to eight lodging units and breakfast to travelers or guests. Forms Needed: Application for Class 11 Permit with fee (check payable to WSLCB) Personal/Criminal History Statement for all applicants Proof of ownership or use of property (such as a lease or a purchase and sale agreement) Please call the Customer Service Desk if you have any questions, at (360) 664-1600. Applicant Information Applicant's Name(s) (First, Middle, Last) Name of Corporation, Partnership, or Limited Liability Company (if applicable) Mailing Address (Street or PO Box, City, State, Zip Code) Contact Person Title Telephone No. ( ) Telephone No. ( ) Business Location Information Name of Business Type of Business (include how alcohol will be served, i.e., with breakfast, in room, etc.) Telephone No. ( ) Location Address (Street or Route, City, State, County, Zip Code) Inside City Limits? Yes No No. of Rooms Available I declare under the penalties of perjury and the revocation of any permit granted, that I am the applicant or the authorized representative of the person(s) or entity making this application. I declare that the answers contained, including any accompanying information, are true, correct, and complete. Signature LIQ 391- 3/10 Title Date American LegalNet, Inc. www.FormsWorkFlow.com
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