The URL can be used to link to this page

11 Alcoholic Beverage License ""i æ~~ .. J . I CUPEIQ1NO AGENDA ITEM NUMBER SUBJECT AND ISSUE City Hall 10300 Torre Avenue Cupertino, CA 95014 (408) 777-3212 Fax' (408) 777-3366 OFFICE OF THE CITY MANAGER SUMMARY \\ AGENDA DATE: February 7, 2006 Application for Alcoholic Beverage License. BACKGROUND 1. Name of Business: Location: Type of Business: Type of License: Reason for Application: RECOMMENDATION Wahoos Fish Taco 19626 Stevens Creek Boulevard (Marketplace) Restaurant On-Sale Beer and Wine for Bona Fide Public Eating Place New Application There are no use pennit restrictions or zoning restrictions which would prohibit this use and staff has no objection to the issuance of the license. Prepared by: ~. 'w~ Cid=' City Planner Submitted by: ~Kn~Uèf City Manager G: IPlanninglMISCELL IABClabc wahoosfish(aco. doc Printed on Recycled Paper f( -( Department of Alcoholic Beverage Control APPLICA nON FOR ALCOHOLIC BEVERAGE LICENSE(S) ABC 21t (6/99) State of California TO: Department of Alcoholic Beverage 100 Paseo de San Antonio Room 119 San Jose, CA 95113 (408) 277-1200 DISTRICT SERVING LOCATION: Control File Number: 435548 Receipt Number: 1549037 Geographical Code: 4303 Copies Mailed Date: January Issued Date: 17, 2006 First Owner: Name of Business: SAN JOSE PACIFIC RESTAURANT GROUP LLC WAHOOS FISH TACO Location of Business: 19626 STEVENS CREEK BLVD CUPERTINO, CA 95014 SANTA CLARA County: Is premise inside city limits? Mailing Address: CIf different from premises address) Yes Census Tract 5080.01 812 S WINCHESTER BLVD STE 130-144 SAN JOSE, CA 95128 Type of licenseCs): 41 Transferor's license/name: License Type Transaction Type / Dropping Partner: Yes No Fee Type Master Dup Date Fee NA y 0 01/13/06 $300.00 NA Y 0 01l13/06 $304.00 Total $604.00 41 ON-SALE BEER AND ORIGINAL FEES 41 ON-SALE BEER AND ANNUAL FEE 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 attachment which shall be deemed part of this application. Applicant agrees Ca) that any manager employed in an on-sale licensed premise will have all the qualifications of a licensee, and Cb) 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: January 13,2006 Under penalty of perjury, each person whose signature appears below, certifies and says: (1) He is an applicant, Of one of the applicants, or un 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 thc contents thereof and that each of the above statements therein made are true; (3) that no person other Il10m the applicant or applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under (he 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 into more 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 ,lilY creditor or transferor or to defraud or injure any creditor of transferor; (5) that the transfer application may be withdr<lwn by either the applicant or the licensee with no resulting liability to the Department. Applicant Name(s) PACIFIC RESTAURANT GROUP LLC æu :% /Vf·"¥'iI(.. y (VINtLt] ~ ~ *See for the 3rd Managing Member** (( - 2. State of California APPLICATION SIGNATURE SHEET ("SIGN ON") Department of Alcoholic Beverage Control · This form is to be used as the signature page for 1. OWNERSHIP TYPE (Check one) applications not signed in the District Office. j 0 Sole Owner 0 Corporation · Read instructions on reverse before complet/ng. I 0 Partnership ŒJ Limited Liability Company · All signatures must be notarized in accordance with . 0 Husband & Wife '[]'Other _......_._ T:~;;U;;E~: ,~:~!e where s!gned._ 3 LICENSE TYPE_~g~~~~~~S~~~~L~d...____ . _____ , :tiZI Oliginal 0 Person to Person Transfer /...\ , I tJ Exchange 0 Premise to Premise Transfer . 0 Other 5 APPLlCANT(S) NAME lll'l~t li'<:.1 mirlrllf!\ I ¡1 A 1!-iF-1 Co Qfif;;~ G1l:/tJ-WP. 4 c.... 6 ;:;~LiN'JG~ESS~~"'"P08Yf6PC~" &U~. j- Vef1Uer. CO__ ÆQJ-30 ~j¡;S~OO~i'::ddG.::r~~ ~._ ~ _ .~t.M_,aL_j~loj___ APi:iJÊANT'S aERTIFICA TlO Under pcnalty of per jury, each person whose signature appears below, certifies and says: (I) !-Ie/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 thaI each of the above statements therein made arc true; (3) that no person olher than the applicant or applicants has any direct or indirect interest in the applicant or ap\1Iicant's business 10 be conducted under the license(s) for which t 1Ìs 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 lIljure any creditor or transferor; (5) thai the transfer application may be wIthdrawn by eilher the applicant or the licensee with no resulting liability to the Department. [understand that if I fail to qualify for the license or withdraw this application therc will bc a service charge of one· fourth of the license fee paid. up to S I 00. ------------------ --------- ---------- --------------- --- I DATE SIGÑED-----·-- I j SIGNATURE __-..-L'L...____ PARTNERSHIP/LIMITED PARTNERSHIP (Signatures of general partners only) 8_ PRINTED NAME (Last first. middle) ----~_. 9. PARTNER'S PRINTED NAME (Last, first, middle) SIGNATURE X _._L. I SIGNATURE 'X 1_-__- I SIGNATURE IX , , PARTNER'S PRINTED NAME (Las1, first. middle) PARTNER·S PRINTED NAME (Last, firsl, middle) CORPORATION .._~----~.. I SIGNATURE Ix 10. PRINTED NAME (las1, first. middle) ---..-- -- .. --------"--_._--- TITLE ____0 President 0 Vice President PRINTED NAME (Last, first. middle) I DATE ŠIGNED . ---1-- I DATE SIGNED I ----L-~ j DATE SIGNED i , ! _.._~ --.._~--_._- --.----- ------------- -- ._----,-~- --- ¡ DATE SIGNED I ------ o Chairman of the Board --"--·---riGNATU~------·_·- X I DATE-SIGN~-------- I --------------- _____n______ TITLE - -- - ------ - -------- o Secretmy 0 Ass!. Secretary 0 Chief Financial Officer D Ass!. Treasurer ______ __________________ _______._ ___________________._..______________ _.______u_ LIMITED LIABILITY COMPANY 11 The limited liability company IS membe~-run -- - - -W Yes 0 No -(If no, compl~;;:;e~- #;;, beIOw)- ~K;~~t~T~~ MAt;: M:M::SIGNA:ED Œ~R:'~'"; m0d., ~_~_-~_ _-rABC-,NITIAlSlDATE (ABC"'~ooy) v"";"~i3~~ J\<ß.,_Œ-:! ~""2_,--,," _ [_oDAATT/Ess-I'GGNN_EE/D·l~_~_ -~MLJER.~ PRINTEDNA~[ (Last first, middleh I SI~- ;¡iii'"-- I X ------------- ABC-211-SIG (2/03) r:~~_r~ ~rÞ "SIGN 0fl." beEG l~eOF~ 5C4Tc OJ[' CocUl£4~ CbUtVT'-! Of:' e A!bU? 1(- .3 ____n._______._ !Ì/urAq