/ Licensing and Regulation
PO Box 43098
Olympia WA 98504-3098
Phone: 360 664-1600
Fax: 360 753-2710
www.lcb.wa.gov
License Number
UBI Number
Trade Name

ADDED ACTIVITIES FOR

TAVERNS

Added Activities Processing Information
1.  / Please answer all sections of this form. Incomplete forms cannot be processed.
2.  / Submit this form and any required documents to the above address.
3.  / The following sections require additional documents to be submitted with this form:
·  Adding an Outside Service Area to an Existing Liquor License and
·  Central Warehousing for Only Wine and/or Spirits.
Note: If you are an *existing liquor licensee adding an outside service area please direct your questions to Customer Service at 360-664-1600.
Do you want any of the following activities?
Live Music/DJ Music / Yes No
Karaoke / Yes No
Dancing / Yes No
Comedy Shows / Yes No
Other:
Outside service area / Yes No
The area must be enclosed with 42” permanent barriers such as ropes and stanchions, railings or fences.
Adding an outside service area to an existing liquor license
(see #3 in Processing Information above) / Yes No

If Yes submit, with this form, two sets of floor plans showing the existing premise with a doorway that leads from the inside of the premise into the outside service area. Professional blueprints are not required. The plan does not have to be to scale.

Self-service beer taps / Yes No
Allows you to have self-service beer taps at the table.
Use of spirits in cooking / Yes No
Allows you to have spirituous liquor on your premises to be used for cooking purposes only.
After hours / Yes No
The sale, service and consumption of alcohol are prohibited by law between the hours of 2:00 a.m. and 6:00 a.m.
Central warehousing for Only Wine and/or Spirits
(see #3 in Processing Information above) / Yes No
If Yes, go to the WSLCB Licensing Forms web page. Select, complete and submit the Warehouse Registration Form with all its required attachments.
Delivery of Beer / Wine / Yes No
Internet Sales / Yes No
(Off-Premises Endorsement required - $128)
If you checked Yes for Internet Sales, will you be using a third party internet provider? / Yes No
Please list the name of the third party internet provider:
Where will the sale of your products (including alcohol) take place?
How do you plan to deliver the product?
How will you be certain only people 21 or older make the purchase and receive the delivery?
Other
Print Name: / Date:
Signature: / Phone: / ()–()-()
Print Title: / E-mail
(for example, sole proprietor, corporate officer,
partner, LLC manager or member.)

LIQ855 4/17