Licensing and Regulation PO Box 43098, 3000 Pacific Ave SE Olympia WA 98504-3098 Phone � (360) 664-1600 Fax � (360) 753-2710 www.lcb.wa.gov LIQUOR ALTERATION REQUEST FORM Use this form to request physical alterations (changes) to your liquor licensed premise. It cannot be used to request a change to your license type. If you wish to change the type of liquor license you have, you must file a Business License Application and any supplemental forms. Alteration requests must be accompanied by photos and 2 sets of floor plans. Floor Plan Requirements: 1. Show dimensions of the following spaces: Walls, dining area, lounge/bar area, openings to lounge/bar, game rooms, dance floor, opening into outside service areas. 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.) Photo Requirements for following items: 1. Must include close up photo approx. 5ft away and medium range photo approx. 15-20ft away. 2. Bar/lounge: Back of the bar (showing taps, sink, work area, etc.) Front of the bar (include stools/seats if seating at bar) Picture of the taps Entry points into the bar area/lounge Barriers separating bar from other spaces (dining area, hallways, common spaces, etc.) Please submit distance shot to show how the barrier sits in the space along with a close up shot with a measuring device (tape measure) to show how high it is (must be 42 inches high). 3. Game areas: Barriers must be at least 42 inches high 4. Outside service areas/sidewalk caf�: Barriers must be at least 42 inches high View from inside showing overall view of outside seating area Openings/entrances into outside service area Licensee information: (To be filled out by licensee) Licensee Name Trade Name Liquor License Number UBI # LIQ 761 11/15 American LegalNet, Inc. www.FormsWorkFlow.com Address Street and Suite/Room/Unit # City , State, Zip Contact Person Email Address Phone No. ( ) - Alteration information: (To be filled out by licensee) Describe the alteration: (attach additional sheets of paper if needed) Signature (Licensee or Authorized Representative) Date LIQ 761 11/15 American LegalNet, Inc. www.FormsWorkFlow.com