Use of Restroom Agreement Form (Seattle, Washington)

This is the official Use of Restroom Agreement Form from Public Health - Seattle & King County. You can fill it in its original layout in your browser or with an AI assistant, then download it to review, sign and submit to the agency.

Form details

Issuer

Public Health - Seattle & King County

Jurisdiction

Seattle, Washington

Type

Food truck and mobile vending permits

Questions

27

Last mapping review

2026-10-02

Official blank PDF from Public Health - Seattle & King County ↗

What this form asks

• Restroom: City
• Restroom: Zip
• Mobile Unit/Food Vendor: Phone
• Mobile Unit/Food Vendor: Zip
• Mobile Unit/Food Vendor: Email
• Available at Restroom: Hot water at hand-wash sink(s) at or above 100°F (checkbox)
• Available at Restroom: Hand soap (checkbox)
• Available at Restroom: Disposable hand towels or other acceptable hand drying device (checkbox)
• Available at Restroom: Required sign or poster which notifies food employees to "wash their hands" clearly visible (checkbox)
• Available at Restroom: Key accessibility to restroom (if applicable) (checkbox)
• Available at Restroom: Distance from food service to restroom shall be 500 feet or less (checkbox)
• Available at Restroom: If seating is provided, then a plumbed restroom allowing customer access must be available within 500 feet (checkbox)
• Restroom: Name of Business
• Restroom: Address
• Restroom: Contact Person
• Restroom: Contact Person Title
• Restroom: Phone
• Restroom: Business Hours of Operation
• Restroom: Email
• Restroom: What retail/service activity takes place at this facility?
• Mobile Unit/Food Vendor: Name of Business
• Mobile Unit/Food Vendor: Owner/Operator
• Mobile Unit/Food Vendor: Address
• Mobile Unit/Food Vendor: City
• Mobile Unit/Food Vendor: Days/Time at Restroom
• Restroom Owner/Agent: Printed Name & Title
• Mobile/Vendor: Printed Name & Title

Review, sign and submit

PaperPorter fills the form but does not submit it or approve anything. Signatures, initials and staff-only areas are left for the right person. Confirm current fees, attachments and filing instructions with Public Health - Seattle & King County.

Other Seattle forms

• Use of Commissary / Shared Kitchen Agreement Public Health - Seattle & King County
• Insignia Application for Food Trucks and Concession Trailers That Do Not Require Plans (F623-040-000) Washington State Department of Labor and Industries, Factory Assembled Structures
• Mobile Food Unit Operational Questionnaire (Appendix J) Public Health - Seattle & King County
• Mobile Food Unit Contact Information for Route or Site Location Public Health - Seattle & King County
• Seattle Fire Department Permit Application, Code 8206 LPG (Propane), CNG, and/or Solid Fuel/Open Flame/Charcoal Used for Food Trucks, Food Booths or Heating, Annual Seattle Fire Department, Fire Prevention Division
• Mobile Approval By Reciprocity Checklist Public Health - Seattle & King County
• 2026 Application for Business License Tax Certificate City of Seattle License and Tax Administration

Food truck and mobile vending permits in other places

• Acknowledgment of New Application Requirements Denver
• Affidavit of Commissary Denver
• Retail Mobile Food Establishment Plan Review Packet Denver
• DBPR HR-7006, Plan Review for Mobile Public Food Service Establishment Florida
• DBPR HR-7022 – Commissary Services Notification Florida
• DBPR HR-7031, Application for Mobile Public Food Service Establishment License with Plan Review Florida
• DBPR HR-7036, Application for Mobile Public Food Service Establishment License Florida
• Mobile Food Truck Notice of Intent Indianapolis

Frequently asked questions

Does PaperPorter submit this form?

No. You download the completed PDF, then review, sign and submit it to Public Health - Seattle & King County yourself.

Can I fill it without an AI assistant?

Yes. Fill it in your browser and download the completed PDF. An assistant such as ChatGPT or Claude can also ask you the questions and fill it for you.