Alteration Request Form
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Alteration Request Form. This is a Washington form and can be use in Liquor Control Board Statewide.
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Tags: Alteration Request Form, 761-50, Washington Statewide, Liquor Control Board
Licensing & Regulation Division
Liquor Control Board
PO Box 43098
Olympia, WA 98504-3098
www.liq.wa.gov
Customer Service Phone: (360) 664-1600
Fax Number: (360) 753-2710
ALTERATION REQUEST FORM
Alteration requests must be accompanied by 2 sets of floor plans to include the
following information:
1. Drawn ΒΌ inch to 1 foot scale
2. North arrow indicator
3. Location of all public entrances (must designate access such as street, alley,
parking lot, and list street names)
4. Name of rooms (dining areas, lounge, tap room, game room, dance floor,
bandstand, etc.)
5. Furniture (tables, chairs, booths, bar, service bars, pool tables, dart boards,
etc.)
6. Outdoor service areas (patio, deck, beer garden, etc.)
Licensee information: (To be filled out by licensee)
Liquor License Number:_______________
Tradename: ______________________________
City: ____________________
Contact Person: __________________________
Phone No. _______________
Alteration information: (To be filled out by licensee)
Describe the alteration: (attach additional sheets of paper if needed)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Signature ____________________________________
Date: ________________
(Licensee or Representative)
LIQ 761-50
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