05. ABC Cypress Hotel & Park Place
CITY OF
CUPEIQ"INO
AGENDA ITEM NUMBER
SUBJECT AND ISSUE
City Hall
10300 Torre A venue
Cupertino, CA 95014
(408) 777-3212
Fax: (408) 777-3366
OFFICE OF THE CITY MANAGER
SUMMARY
s
AGENDA DATE June 19,2007
Application for Alcoholic Beverage License.
BACKGROUND
1.
Name of Business:
Location:
Type of Business:
Type of License:
Reason for Application:
RECOMMENDATION
Cypress Hotel & Park Place Restaurant & Bar
19930-19936 Stevens Creek Blvd (Corner of De Anza &
Stevens Creek Blvd.)
Hotel & Restaurant
On-Sale General for Bona Fide Public Eating Place and On-
Sale General for Public Premises (47 & 48)
Person-to-Person & Annual Fee
There are no use permit restrictions or zoning restrictions which would prohibit this use and staff
has no objection to the issuance of the license.
Prepared by:
...-I
C~i~~
Submitted by:
ftsL
David W. Knapp, City Manager
Printed on Recycled Paper
Department of Alcoholic Beverage Control
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6/99)
State of Cal ifornia
TO: Department of Alcoholic Beverage
100 Pas eo de San Antonio
Rm. 119
San Jose, CA 95113
(408)277-1200
DISTRICT SERVING LOCATION:
Control
File Number: 454498
Receipt Number: 1616681
Geographical Code: 4303
Copies Mailed Date: May 31, 2007
Issued Date:
First Owner:
Name of Business:
SAN JOSE
RP SCS CUPERTINO HOTEL LLC
CYPRESS HOTEL & PARK PLACE REST A URANT & BAR
Location of Business:
10050 S DE ANZA BLVD
CUPERTINO, CA 95014-2128
SANTA CLARA
County:
Is premise inside city limits?
Mailing Address:
(If different from
premi ses address)
Yes
Census Tract 5080. () 1
13155 NOEL RD
STE 700
DALLAS, TX 75240
Type of licensees):
47,58
Transferor's license/name:
388521 / CUPERTINO HOT Dropping Partner:
Yes
No
License Type Tran sacti on Type Fee Type Master Dup Date
47 ON-SALE GENERAL] PERSON TO PERSON TRANSF P40 y 0 05/31/07
47 ON-SALE GENERAL) ANNUAL FEE P40 Y 0 05/31/07
58 CATERER PERMIT DUPLICATE NA N 1 05/31/07
30 TEMPORARY PERMI DUPLICATE NA Y 1 05/31/07
47 ON-SALE GENERAL ] STATE FINGERPRINTS NA N 3 05/31/07
47 ON-SALE GENERAL] FEDERAL FINGERPRINTS NA N 3 05/31/07
Total
Fee
$1,250.00
$758.00
$110.00
$100.00
$117.00
$72.00
$2,407.00
Have you ever been convicted of a felony? No
Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the
Department pertaining to the Act? No
Explain any "Yes" answer to the above questions on an allachment which shall be deemed part of this application.
Applicant agrees (a) that any manager employed in an on-sale licensed premise will have all the
qualifications of a licensee, and (b) that he will not violate or cause or permit to be violated any of the
provisions of the Alcoholic Beverage Control Act.
STATE OF CALIFORNIA County of SANTA CLARA Date: May 31, 2007
Under penalty of perjury. each person whose signature appears below. certifies and says: (1) He is an applicant. or one of the applicants. or an
executive officer of the applicant corporation. named in the foregoing application. duly authorized to make this application on its behalf; (2) that
he has read the foregoing and knows the contents thereof and that each of the above statements therein made are true; (3) that no person other
than the applicant or applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under the licensees) for
which this application is made; (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an
agreement entered imo more than ninety (90) days precedlllg the day on which the transfer application is filed with the Department or to gain or
establish a preference to or for any creditor or transferor or to defraud or injure any creditor of transferor; (5) that the transfer application mal'
be withdrawn by either the applicant or the licensee with no resulting liability to the Department.
Applicant Name(s)
Applicant Signature(s)
RP SCS CUPERTINO HOTEL LLC
Sep 211 Sip;nlltllrP PlIP;P
Department of Alcoholic Beverage Control
State of California
APPLICATION SIGNATURE SHEET ("SIGN ON")
. This form is to be used as the signature page for
applications not signed in the District Office.
Read instructions on reverse before completing.
All signatures must be notarized in accordance with
laws of the State where signed.
2, FILE NUMBER (i1 any)
3, LICENSE TYPE
388521
47, 58
5, APPLlCANT(S) NAME (Lasl. flrsl. mIddle)
RP SCS Cupertino !-Iotel LLC
1 OWNERSHIP TYPE (Check ana)
D Sole Owner
o Partnership
D Husband & Wife
D Partnership-Ltd
D Corporation
[;] Limited Liability Company
D Other
4 TRANSACTION TYPE
D Original
D Exchange
o Person to Person Transfer
D Premise to Premise Transfer
D Other
6, APPLICANT'S MAILING ADDRESS (Slreal addrass/P,O, box. clly. slale. Zip code)
13155 Noel Road, Suite 700 Dallas, Texas 75240
7, PREMISES ADDRESS (Slreel address. city. ZIp code)
10050 S, De Anza Blvd., Cupertino, CA 95014 ~ !l. I J ~
APPLICANT'S CERTIFICA TION
Under penalty of peljury, each person whose signature appears
below, certifies and says: (I) He/She is an applicant, or one of
the applicants, or an executive officer of the applicant
corporation, named in the foregoing apQlication, duly authorized
to make 1I11S application on its behalf; (2) that he/she has read
the foregoing and knows the contents thereof and that each of the
above statements therein made are true; (3) that no person other
than the a\Jplicant or applicants has any direct or indirect interest
in the app icant or applicant's business to be conducted under the
licensees) for which this application IS made; (4) that the transfer
application or proposed transfer is not made to (a) satisfy the
SOLE OWNER
payment of a loan or to fulfill an agreement entered into more than
ninety (90) days preceding the day on which the transfer
application is filed with the Department, (b) to gain or establish a
preference to or for any creditor or transferor, or (c) to defraud or
Illjure any creditor or transferor; (5) that the transfer application
may be withdrawn by either the applicant or the licensee with no
resulting liability to the Department.
I understand that if I fail to qualify for the license or withdraw thiS
application there will be a servIce charge of one-fourth of the
license fee paid, up to $ I 00,
8, PRINTED NAME (Last. flrsl. middla)
I ~GNATURE
I DATE SIGNED
PARTNERSHIP/LIMITED PARTNERSHIP (Signatures of general partners only)
9, PARTNER'S PRINTED NAME (Last. first. middle) ! SIGNATURE DATE SIGNED
Ix
PARTNER'S PRINTED NAME (Lasl. Flfsl. middle) SIGNATURE DATE SIGNED
x
DATE SIGNED
PARTNER'S PRINTED NAME (Last. first. middle)
SIGNATURE
x
CORPORATION
10, PRINTED NAME (Las I. first. middle)
I ~GNATURE
I DATE SIGNED
TITLE
D President D Vice President
PRINTED NAME (Last. first. middle)
D Chainnan of the Board
I ~GNATURE
I DATE SIGNED
TITLE
o Secretary 0 Asst. Secretary 0 Chief Financial Officer 0 Asst. Treasurer
LIMITED LIABILITY COMPANY
11, The limited liability company is member-run
ABC INITIALSIDATE (ABC use only)
[;]Yes DNa
(If no, complete Item #12 below)
12, NAME OF DESIGNATED MANAGER, MANAGING MEMBER OR DESIGNATED OFFICER (Lasl, flrsl, middle)
13, MEMBER'S PRINTED NAME (Lasl, flfst. middle)
/
Alhi I 1;0 I tou 7
I DATE SIGNED
/ VOvw.icIZ \L Fox
I
I SIGNATURE
iX
"SIGN ON"
MEI~BER'S PRINTED NAME (Last. rlfst. middle)
ABC-211-SIG (2/03)
)/
LJ/ L ~l \
I) _(;,i
DATE SIGNED
J~d-;~
'..,.
STATE OF TEXAS ~
~
COUNTY OF DALLAS ~
On April 30, 2007, before me, Susan A. Vergenz, Notary Public, personally appeared
Patrick K. Fox, personally Imown to me to be the person whose natTle is subscribed to the
within instrument (ABC-211-S1 G), and aclmowledged to me that he executed the same in
his authorized capacity, and that by his signature on the instrument the person, or the entity
upon behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Slg~~e~;V~
Susan A. Vergenz
SUSAN A. VERGENZ
Notary Public
8T A TE OF TEXAS
My Comrn. f:l\p. Oct. 31,2010
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