Application For Class 11 Permit Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application For Class 11 Permit Form. This is a Washington form and can be use in Liquor Control Board Statewide.
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Tags: Application For Class 11 Permit, LIC 391-51, Washington Statewide, Liquor Control Board
For Office Use Only
Liquor Control Board
Licensing and Regulation
PO Box 43098
Olympia WA 98504-3098
www.liq.wa.gov
FAX 360/753-2710
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)
Telephone No.
Contact Person
(
)
Telephone No.
Title
(
)
Business Location Information
Name of Business
Telephone No.
(
)
Type of Business (include how alcohol will be served, i.e., with breakfast, in room, etc.)
Location Address (Street or Route, City, State, County, Zip Code)
Inside City Limits?
Yes
No. of Rooms Available
No
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
Title
Date
LIQ 391-51 2/99
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