Temporary Food Permit Application -- EXEMPT Menu

What to expect: When your application is submitted, you will be shown a receipt. You will also receive an email from noreply@skipthepaper.com. If you do not receive the email, please check your email program's spam filter and spam settings.

Required fields are indicated with red.

Applicant's Address
First Name:
Last Name:

Business Name:

Street 1:

Street 2:

City:
State:
Zip/Postal:


Doing Business As Name:
Email (will receive email updates):
Phone:
Question Section
QuestionAnswer
Food Preparation
Does your operation require any of the following:
  • Advanced menu preparation
  • Use of fruits and or vegetables that are not purchased pre-washed or pre-cut
  • Food preparation for an event lasting longer than one day (requires access to a 3 compartment sink for dishwashing)
Event Equipment List
Which method of hand washing station will your operation utilize?

Warm handwash water, soap, and paper towels are required at all times.


An approved sanitizer method is required to be maintained at 50-100 ppm bleach solution. Which method(s) will your operation utilize?

Certification
I certify that I have read, understand, and agree to comply with the "Temporary Events Operating Requirements" handout. Understand that if I don’t comply with the requirements, my establishment will be closed.
I certify that a Person In Charge (PIC) with a valid Washington food worker card will be present in the temporary food establishment at all times.
I understand that it is required that I have a bathroom facility available within 200 feet of my operation.
I certify that the permit category that I have selected matches the requirements set forth within the Temporary Food Establishment Fee Schedule and Guidelines, and that I may be closed or charged additional fees for incorrect information.
I understand that if critical violations are found during the operation under this permit, a reinspection fee may be assessed by the Health District at the current fee schedule rate.
I understand that if the information that has been supplied is incorrect or changes, I am responsible for updating the Health District. If the Health District attempts to perform an inspection based upon incorrect information provided, I may be charged a reinspection fee.
I understand that if my operation requires an approved kitchen that I must submit a signed Commissary Kitchen Agreement form authorizing my operation to use the approved kitchen (If N/A answer Yes).

Failing to attach the Commissary Kitchen Agreement Form, for operations requiring the use of an approved kitchen, may result in delay or denial of this application.
Permit Categories (Informational)
NO FEE LOW RISK EXEMPT FOODS

Certain foods and beverages that have minimal risk of causing foodborne illness may be exempted from permit fees. However, we must review your food items through this form. Please review the Kitsap Exempt Handout for details on what qualifies.
Supplemental Information
Please provide any additional information which you feel is helpful for us to know about your operation.
Additional Information
Specific Attachments
NOTE: PDF, JPG and GIF files are allowed. File size limit is 5 Megabytes.
Items marked with * are required. 

USDA license
If you are licensed through the United States Department of Agriculture, please attach a copy of the license.

Commissary Kitchen Agreement Form
Operations which require a commissary kitchen must attach the Commissary Kitchen Agreement Form.

WSDA license
If you are licensed through the Washington State Department of Agriculture, please attach a copy of the license.

Terms and Conditions

By clicking on the Submit button below, you agree to the terms and conditions outlined above.



ORME Application v3.0