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07a&b. ABC Vinety Faire & Baja Fresh...- x.. .: CAN ~F CUPEI~TINO City Hall . 10300 Tarre Avenue Cupertino, CA 950I4 {408)777-3212 ___ Fax: (408) 777-3366 OFFICE OF THE CITY MANAGER SUMIIZARY AGENDA ITEM NUMBER SUBJECT AND ISSUE Application for Alcoholic Beverage License. BACKGROUND 1. Name of Business: Location: Type of Business: Type of License: Reason for Application: RECOMMENDATION Vinety Faire 10478 Bom~y Drive Internet AGENDA DATE _. ~- _.et, x,., ~ ~`~ Beer & Wine Wholesaler (17), Off Sale Beer & Wine (20} Original & Annual Fees, Fingerprinting 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. License Type 20 authorizes the sale of beer and wine for consumption off the premises where sol~I. Prepared by: Colin J , Se ' r Planner G:planning/misc/abc vinery faire Submitted by: ~~ David W. Knapp, City Manager 7a-1 Printed on Recycled Paper Department of Alcoholic Beverage Control State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) ABC 211 (G/99) TO: Department of Alcoholic Beverage Control File Number: 472206 100 Paseo de San Antonio Receipt Number: 1683753 Rm. lI9 Geographical Code: 4303 San Jose, CA 95113 Copies Mailed Date: September 23, 2008 (408)277-1200 Issued Date: DISTRICT SERVING LOCATION: SAN .TOSE First Owner Name of Business: Location of Business County: Is premise inside city limits? Mailing Address: (If different from premises address) Type of license{s): 17, 20 Transferor's license/name: FAS)FTBOYLE ROBIN DOROTHEA vnvE~I~ FAm>~ 10478 BONNY DR CUPERTINO, CA 95014-2947 SANTA CLARA Yes Census Tract Dropping Partner: Yes No License Type Transaction Tape Fee T Master Dun to Fee 17 BEER AND WINE WI ORIGINAL FEES NA Y 0 0 9 / 2 3 / 0 8 $100.00 ]7 BEER AND WINE WI ANNUAL FEE NA Y 0 09!23/08 $269.00 20 OFF-SALE BEER ANL ORIGINAL FEES NA Y 0 . 0 9 / 2 3 / 0 8 $100.00 20 OFF-SALE BEER ANL ANNUAL FEE NA Y 0 0 9 / 2 3 / 0 8 $220.00 20 OFF-SALE BEER ANL STATE FINGERPRINTS NA N 2 0 9 / 2 3 / 0 8 $78.00 20 OFF-SALE BEER ANL FEDERAL FINGERPRINTS NA N 2 0 9 / 2 3 / 0 8 $48.00 Total $815.00 Have you ever been convicted of a felony? N o Have you ever violated any provisions of t he Alcoholic Beverage Control Act, or regulations of the Department pertainin g to the Act? No Expluiu any "Yes" answer to the above questions on an attachment which shal l 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: September 23> 2008 Under penalty of perjury, each person whose signature appears below, certifies and says: (1) lie is an applicant, or one of the applicants, or an executive officer of the applicant corporation, named in the foregoing application, duly authorized to rrwke 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 thus the applicant or •rpplia:nts has any direct or indirect interest is the applicant or applicant's business to be conducted under the license(s) for which [his application is mude; (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an agreement entered into more thau ninety (90) days preceding the day on which the transfer application is d with the Department or to gain or establish a preference to or for arty creditor or transferor or to defraud or injure any creditor of transfe r; 5) that the transfer application may be withdrawn by either the applicant or the licensee with no resulting liability to the Departmen . Applicant Name(s) ~ppl~ant Siure~ FASHBOYLE ROBIN DOROTHEA 7a - City Natl 10300 Torre Avenue Cupertino, CA 95014 (408) 777-3212 Fax: (408} 777-3366 OFFICE OF THE CITY MANAGER SUMrviARY AGENDA ITEM NUMBER 7~______ SUBJECT AND ISSUE Application for Alcoholic Beverage License. BACKGROUND Name of Business: Location: Type of Business: Type of License: Reason for Application: RECOMMENDATION AGENDA DATE Ce~~~ ~~, ~C Baja Fresh 20735 Steven; Creek Boulevard, H Restaurant No.41, On Sale Beer and Wine. Original and Annual Fees There are no use permi# restrictions or zoning restrictions which would prohibit this use, and staff has no objection to the issuance of the license. Prepared by: Colin Ju r Planner G:planning/misc/abc/abcBaj aFeesh Submitted by: ~~ David Knapp, City Manager 7b-1 Printed on Recycled Paper Department of Alcoholic Beverage Control State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE{S) , ABC 211 (6199) TO: Department of Alcoholic Beverage Control File Number: 472347 100 Paseo de San Antonio Receipt Number: 1684329 Rm. 119. Geographical Code: 4303 San 3ose, CA 95113 Copies Mailed Date: September 26, 2008 (408)277-1200 Issued Date: DISTRICT SERVING LOCATION: SAN .IOSE First Owner: Name of Business: Location of Business: County: Is premise inside city limits? LALLA HOLDING CORD BAJA FRFSH 20735 STEVENS CREEK BLVD #H CUPERTINO, CA 95014-2104 SANTA CLARA Yes Census Tract 5078.06 Mailing Address: (If different from premises address) Type of license(s): 41 Transferor's license/name: Dropping Partner: Yes No License Tvne Transaction Tvne Fee Type Master j2~ Date ~ Fee 41 ON-SALE BEER AND ORIGINAL PEES NA Y 0 0 9 / 2 S /0 8 $300.00 41 ON-SALE BEER AND ANNUAL FEE NA Y O 0-9 / 2 5 / 0 8 $304.00 4 f ON-SALE BEER ANl) FEDERAL FINGERPRINTS NA N 2 0 9/ 2 8/ 0 8 $48.00 4 f ON-SALE BEER AND STATE FINGERPRIN'T'S NA N 2 0 9/ 2 5/ 0 8 $78.00 Total $730.00 Have you ever been convicted of a felony? N o 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' uttswer to the above questions on an attachment 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: September 25, 2008 Linder penalty of perjury, each person whose sigttuture 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 hrs 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 uny direct or indirect interest in the applicant or applicant's business to' be conducted under the licenses} for which this application is made; (4) that the [rtutsfer application or proposed transfer is nol made to satisfy the payment of a loan or to fulfill an agreement entered into mare than ninety (90) days preceding the day on which the transfer application is filed with the Department or to gain or establish a preference to or for ttny creditor or transferor or to defraud or injure any creditor of transferor, (5) that the transfer application may be withdrawn by either the applicant or the licensee with no resulting liability to the Department. Applicant Names} Applicant Signature(s) LALLA HOLDING CORD 4rp 297 Signature Page 7b-2 State of California APPLICATION SIGNATURE SHEET ("SIG1V ON") Department of Alcoholic Beverage Control • This form is to be used as the signature page for Sole oarler applications not signed in the District Office. • Read instructions on reverse before completing. Partnership tl signatures must be notarized in accordance ~ Married Couple with laws of the State where signed. Domestic Partner Partnership-Ltd Corporation ~Limlted Liabil'Ity Company Other 2. FILE NUMBER (If arty) 3. LIGtIVSt i rrt +- irvu+~+~~~~~~~ Original Person to Person Transfer ~., Exchange Premise to Premise Transfer Other ~. rte,-,...,~.,., ~ ... ......... .wM, .....~ ..........., &. APPLICANTS MAILING ADDRESS {Street eddresslP.O. box, coy, stale, zip code) t33~-1 (~.v1'Ic~ R'D, ~»41RA-Toss C1~ 9s~~ 7. PREMISES ADDRESS (Street address, city, zip code) ~~ ~~ ~o~ 3~ s'c ~'~~ Ng ~~ ~t~Cl~c g1 vD . c c~ z'F~~-r ~ rv o c ~ ~ ~o y ~ APPLICANT'S CERTIFICATION Under penalty of perjury, 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 application, duly authorized to make this 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 tnae; (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 license(s) for which this application is made; (4) that the transfer 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 injure 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 ofone-fourth of the [icense fee paid, up to $100. B. ? OWNER middle) PARTNERSHIP/UNITED PARTNERSHIP (Signatures of general partners only} 9. PARTNER'S PRINTED NAME tLas4 oral, middle) SIGNATURE DATE SIGNED X .. X CORPORATION lir:1~L9 X ~~~~ ~ ~ ~~~;~ ~ X Vice President Chairman of the Board jyl+D'DI (' H lA Nl ~ ( x 9~Id ~ Q~ s3~ -ter . ~ b' TITLE Q/Yj~-c.t. G'e. Secretary Asst. Secretary Chief Financial Officer ©Asst. Treasurer LIMITED LIABILITY COMPANY 11. The limited liability company is member-run ~`Ces ~No (If no, complete Item #12 below) 12. NP.ME OF DESIGNATED MANAGER, MANAGING MEMBER OR DESIGNATED OFFICER (Lest, fret, triMdtrq a 1~5Iv~ ABC-211-SIG (6108) "SIGN ON"