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09. Green Valley Liquor ABC .'.:,\ ,. li.\ ~ L,., L CUPEIUINO L .L y .' City Hall 10300 Torre Avenue Cupertino. CA 95014. (408) 777-3212 Fax: (408) 777-3366 OFFICE OF TIlE CITY MANAGER SUMMARY AGENDA ITEM NUMBER , AGENDADATE 'VI,fo,. SUBJECf AND ISSUE . Application for Alcoholic Beverage License. BACKGROUND 1. Name of Business: Location: . Type of Business: Type of License: . Reason 'for Application: ' Green Valley Liquor 10073 Saich Way Liquor Store Off Sale General (21)' . Person 1'0 Person Transfer and Annual Fee . RECOMMENDATION . 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: Submitted .by: ~. . 0 . CiddYWorde .City~ ~ David W. Knapp~ CityManager Prtmd an Recycled PIIptIr 9 -1 Department of Alcoholic Beverage Control APPLICATION FOR ALCOHOLIC BEVERAGE LlCENSE(S) ABC 211 (6199) State of California TO: Department of A.lcoholic Beverage 100 Paseo de San Antonio Rm. 119 San Jose, CA 95113 (408)277-1200 DISTRICf SERVING LOCATION: Con.trol File Number: 457697 Receipt Number: 1628098 Geographical Code: 4303 Copies Mailed Date: August t~; i007 Issued Date: -..-/ Location of Business: S~ JOSE PEREZ ROBERTO SERRANo GREENVAILEYUQUOR 10073 SAICH WY CUPERTINO, CA 95014-2124 SANTA CLARA First Owner: Name of Business: County: Is premise inside city limits? .Mai1ing.._A.d4(~~.s:_ .____________ . .:(If different from premises. address) Type of Iicense(s): 21 Transferor's license/name: Yes . Census Tract 5078.06 405872 I THACH KEVIN , Dropping Partner; Ycs_ NX License Type Transaction Type Fee 'rype Master Illu2 om', fu 21 OFF-SALE GENERAL PERSON TO PERSON TRANSF NA Y 0 08/23/07 $1,274.00 21 OFF-SALB GENERAL ANNUAL }lEE NA Y 0 08/23/07 $507.00 --J 21 OFF-SALE GENERAL STA TBPINGERPRINTS NA N 1 08/23/07 $39.00 21 OPF-SALB GENERAL FlIDERAL FINGERPRINTS NA N 1 08/23/07 $24.00 Total $1.844.00 Have you ever been convicted of a felony? No Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the Department pertaining to the Act? No &pJaiu allY 'Ye,s' answer to the above questiOD$ 011 aD luachlDClllt which shan be deemed pan 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: August 23, 2007 Under pc:nalty of perjury, each pClfSOII wbose algnatllre appean below. certifies aDd IIIYS: (I) He is an applicmt. or ODe of the applicants, or all executive officer of the applicant corporatiOll, Dlmed in the foregoing applleatiOll, duly authorized to make this application 011 its bl:ba1f; (2) that he bas read the foregoing and kllows the contents thereof and thaI CllIeh of the above statemenla therein made are ltUe; (3) that DO persoll otha ' than tbe appliclnt or appllcallts hIlS allY direct or indirect interest III the applicant or Ipplicant's busincss to be collducted under the Iictlosc(s) for which this application is made; (4) that the tralL\fer applicatioll or proposed trallsfer II not made to satisfy the pIIymcnt of a loall or to fulfill In agreement entered into more thall ninety (90) days precedina the day on which the traMfer application is flied with the DeplU'tl1lent or to alin or establish a preferellce to or for any creditor or transferor or to defraud or injure any creditor of trallsferor: (5) that the: transfer application may he withdrawn by either the applicant. or the licensee with no resulting liability to the Department. . Applicant Name(s) A plic PEREZ ROBERTO SERRANO . f/ii\ J ~,