INSTRUCTIONS FOR COMPLETING DBPR ABT – 6023 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO SPECIAL LICENSE INSPECTION FORM Application begins on page 2 If you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation. Please submit your completed application to your local district office. Submission may be done by mail, through appointment or dropped off at your local district office. A District Office Address and Contact Information Sheet can be found on AB&T’s page of the DBPR web site at the link provided below. http://www.state.fl.us/dbpr/abt/contact/index.shtml GENERAL INSTRUCTIONS Please complete all information. All questions are applicable and must be answered fully and truthfully. This application is taken under oath. Persons filing false applications or information may be prosecuted and the application denied. APPLICATION REQUIREMENTS All applicants for Special Restaurant or Hotel licenses must complete the applicant information portion only of this form and submit it to the Division of Alcoholic Beverages & Tobacco. A copy of the sketch of the premises that is submitted with your application for licensure must accompany this form. APPLICATION CHECKLIST TRANSACTION Special License Inspection Form APPLICATION REQUIREMENTS • • Complete DBPR ABT-6023 Division of Alcoholic Beverages and Tobacco Special License Inspection form Copy of sketch of premises 1 American LegalNet, Inc. www.FormsWorkflow.com DBPR ABT-6023 – Division of Alcoholic Beverages and Tobacco Special License Inspection Form STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 1940 North Monroe Street Tallahassee, FL 32399-0783 If you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation. Please submit your completed application to your local district office. Submission may be done by mail, through appointment or dropped off at your local district office. A District Office Address and Contact Information Sheet can be found on AB&T’s page of the DBPR web site at the link provided below. http://www.state.fl.us/dbpr/abt/contact/index.shtml SECTION 1 - APPLICANT INFORMATION Full Name of Applicant (if this is a corporation or other legal entity, enter the name as registered with the Secretary of State) Trade Name (D/B/A) Telephone Number Current Location Address City State Zip Code SECTION 2 - TO BE COMPLETED BY THE DIVISION PERSONNEL Full Name of Applicant: Food Service – Special Restaurant License Square footage of entire premises to be licensed • Includes any space used exclusively in the operation of the restaurant, including but not limited to, kitchens, food service areas, pantries, storage rooms, offices and bathrooms. • Must be contiguous and under the management and control of a single, licensed restaurant establishment. The premises is: at least 1,800 sq. ft. at least 2,500 sq. ft. at least 4,000 sq. ft. at least 5,000 sq. ft. 2 at least 3,000 sq. ft. American LegalNet, Inc. www.FormsWorkflow.com Number of patrons that can be seated and served at one time • Tables and seating must be located within the square footage floor space and under permanent cover, which may include canopies, roll back awnings, etc., which are permanently attached to the building. Seats must be actually set up at time of inspection/verification and must not exceed the occupancy load established by the local fire authority. • Tables must be adequate size to accommodate the service of full course meals in accordance with the number of chairs or other seating facilities provided at the table. • Seating at counters used to serve food can be included in the minimum seating requirements. • Must have on the premises all equipment for the service of full course meals to the applicable number of patrons at one time. A full course meal includes a salad or vegetable, entrée, beverage and bread which must be available at all times alcoholic beverages are being served. The premises can seat: at least 100 persons at least 125 persons at least 150 persons at least 200 persons Lodging – Special Hotel/Motel/Motor Court License Number of guest rooms available for rental • Must be licensed as a public lodging establishment by the Division of Hotels and Restaurants. The premises consists of: at least 50 rooms at least 75 rooms at least 80 rooms at least 100 rooms _____________________________________________________________________ Division of Alcoholic Beverages & Tobacco Inspector (Please Print) _____________________________________________________________________ Signature Date Comments: American LegalNet, Inc. www.FormsWorkflow.com 3