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20. Bingo permit renewalsOFFICE OF THE CITY CLERK CUPERTINO Agenda Item No. ~ ~ SUBJECT AND ISSUE Meeting Date: January 19, 2009 Consider renewing bingo permits for the Cupe~~tino Senior Center Coordinating Council and St. Joseph of Cupertino Church. BACKGROUND The Cupertino Coordinating Council and St. Joseph of Cupertino Church have applied for the annual renewal of their bingo permits as required by the Municipal Code. All forms and fees have been received. The Sheriff s Department, Central Fire Protection District, the County Health Officer, Cupertino's Chief Building Inspector and Director of Planning have approved the applications. RECOMMENDATION: Conduct the public hearing and renew the perrruts. Submitted by: Kimberly Sm~; City Clerk SIJ)'-ZMARY Approved for submission: C C David W. Knapp City Manager Attachments A: Application for Cupertino Coordinating Co~mcil B: Application for St. Joseph of Cupertino Chu~xch CITY HALL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 TELEPHONE: (408} 777-3223 • FAX: (408} 777-33fifi 20-~ f~ ~~h ~.~`t~ /f OFFICE OF THE CITY CLERK CITY HALL CUPERTINO arc ~ s zoaa CUPERTINO CITY CLERK 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223 • FAX: (408) 777-3366 APPLICATION FOR BINGO PERMIT Name of Organization~zi~~p r~~l ~) p ~~p tpf ~-t~'}t',~'" ~hnr7~V?~ ~DL-Y1L~ t Name of Officers Address of Officers ~ ~~ ~.{~-t~ ~y~~~ ~~L[~Q.,t 2. Days of operation Oi~L ' - Hours of Operation ~ -- ~ Yh 3. Address of Bingo game ! S 1 J~-~s _ Bev ~~Szy1~ 4. Purpose of premises used by organization ~C~-1V i~,ES •~~ St~.v~ i b-~'`s 5. Ownership of Bingo equipment p,~--~ t~ o u~ Y~ ~ x- 6. Name of person responsible for operation of Bingo game rY1Gt.nc~ct Cr!.f l/C~... 7. Name of everyone who has any fmancial interest in Bingo game 7'r~dly~r~ucx! ~P:~n~ar~.~~~r'S MUST HAVE THE FOLLOWING CHECK 1~ A. Consent for Sheriff to inspect bank account containing Bingo profits. B. Statement of ownership/lease of premises. C. Copies of exempt status from Internal Revenue and Franchise Tax Board or tax identification number. D. Floor plan of room where gaming will take place showing the exit(s) .~G~ ~~i Signature of person response le for Binga game FEE: $50.00 -General License annual. Over 10 games. 5.00 -General License each game. Under 10 games. THIS PERMIT IS NONTRANSFERABLE EITHER AS TO THE LICENSE OR LOCATION Sheriff recommendation Fire District Health Officer Chief Building Inspector Director of Planning Time of public hearing _ Business License No. FOR OFFICIAL USE ONLY YESA•W NO ~~'E~ ~T~s1~~v~NG-~OrI~S.C.co.S.o~ YES.~`1/ NO YES •V~4 NO U~a~ c©N~C~MA-rloN t(2oM NEA~TN YENO (NS~EcTO(Z SAMANTHA KaNN YES~NO zo-z Cupertino Senior Center Coordinating Council Dorothy Lynn Irving 5635 West Walbrook Drive San Jose, CA 95129 Barbara Burrell 1379 Luning Dr. San Jose, CA 95118 Melissa Yu 10299 McKlintock Ln. Cupertino, CA 95014 Joan Spitsen 1142 So. Blaney Ave. San Jose, CA 95129 Amanda Cuva 18890 Tuggle Ave. Cupertino, CA 95014 20-3 .~~u ..,, .. ~., ~._.....b ~.~....., 3.,. u~ ...~...,.. a.,.,..r...,.. From: epostcard@urban.org To: barbaraburrelll@aol.com Subject: Form 990-N E-filing Receipt -IRS Status: Accepted Date: Tue, Oct 27, 200911:41 am Organization: CUPERTINO SENIOR COORDINATING EIN: 94-2853675 Submission Type: Form 990-N Year: 2008 Submission ID; 7800582009300dh40292 e-File Postmark: 10/27/2009 2:35:19 PM Accepted Date: 10/27/2009 J The TRS has accepted the e-Postcard described above. Please save this receipt for your records. Thank you for filing. e-Postcard technical support Phone: 856-255-0654 {toll free) email:ePo~tcard@urban_orp -------------------------------------------------------------------------- CUPERTINO SENIOR COORDINATING 21251 Stevens Creek Blvd Cupertino, CA 95014 20-4 http://webmail.aol.com/28878/aoI-1/en-us/mail/PrintMessa~e.aspx 10/27/2009 CHASE !.r ~,fPMorgan Chase Bank, N.A. P O Box 260180 Baton Rouge, LA 70826-01 80 J..~LbIL.~~~~iLl„ICI,I~I~„I~~~II,~IL~I~I~~,.IILI~~ 00036800 ORE 703 Iqt 33503 - YNNYN T 1 000000000 62 0000 CUPERTINO SENIOR COORDINATING COUNCIL 21251 STEVENS CREEK BLVD CUPERTINO CA 95014-5713 Y October 31, 2009 through November 30, 2009 Account Number: 000003143755582 CUSTOMER SERVICE INFORMATION Web site: Chase.com Service Center: 1-B00-242-7338 Hearing Impaired: 1-800-242-7383 Para Espanol: 1-888-622-4273 International Calls: 1-713-262-1679 IMPORTANT NOTICE ABOUT YOUR ACCOUNT We strictly prohibit the use of your accounts to conduct any transactions involving unlawful Internet gambling or any other illegal activity. This includes accepting or receiving any funds or deposits to your accounts from unlawful Interne# gambling or other illegal activity. If you haul; any questions, please cast us at 1-800-CHASE38 (1-800-242-7338). , CHECKING SUMMA Chase Free Business Checking INSTANCES AMOUNT Beginning Balance $1,984.26 Ending Balance 0 $1,884.26 There has been no activity on your account during this statement period. You may not receive a statement through the mail in the future if there is no activity on your account. You can always view your account activity and statement by logging on to your account through chase.com. If you have questions, please call us at the nurrlber on this statement. SERVICE CHARGE SUMMARY TRANSACTlQNS FOR SERVICE; FEE CALCULATION Checks Paid /Debits Deposits /Credits Deposited Items Transaction Total SERVICE FEE CALCULATION Service Fee Service Fee Credit Net Service Fee Excessive Transaction Fees {Above ) Total Service Fees NUME3ER OF TRANSACTIONS 0 0 0 0 AhIOUNT ~o.oo ;0.00 :$0.00 .60.00 :60.00 20-5 Page 1 0l q `~k CITY OF CUPE~TIN~ ~Xr~ -m.c~r'kec:1 a~ ~er;P wi~~ X DECK Cupertino Senior Center 21251 Stevens Creek Boulevazd Cupertino, CA 9503.4-3255 {Q:Qg) 77% 3150 fax: t4t38) T79-3156 PARKS AND RECREAA'CION DII'ARTNID~IT { x ~/ Receptbn Hall _~ L~ __ 1 (i0Iif61'~n(:8 At10I7t ~ ~,~; . ~ %~ i + ~ ~ i ~~ f.. . t- ~~ O -~ ~~_ Lounge , ! Main Erb PATI d Zo-s f~-~c~ ~.~.t ~ Q C~C~C~QdC~ ~ ~ Gs o~c .~ 200 CUPERTINO OFFICE OF THE CIl'Y CLERK CUPERTtNQ CITY CLERK CITY HALL 10300 TORRE AVE~JUE • CUPERTINO, CA 95014-3255 TELEPHONE: (408) 777-3223 • FAX: {408} 777-33fi6 APPLICATION FOR BINGO PERMIT 1. Name of Organization Name of Officers Address of Officers 2. Days of operation ~ ~ -~ ~~' :Hours of Operation z(~ ~O ,o •`t'p - I ; tip ~--( 3. Address of Bingo game ~p 1~2 ~. ~~~ 1~~.1-1 `I3~Ut^~ • f~PF'Ri 1 xfY~ _ C`,i'~r . Rol ~f 4. Purpose of premises used by organization S. Ownership of Bingo equipment ~~~`~ ~~ C~ ~?i7 ~ ~ C j 6. Name of person responsible for operation of Bingo game t=U ~' 7. Name of everyone who has any financial interest in Bingo game MUST HAVE 'CHE FOLLOWING CHECK ~ A. Consent for Sheriff to inspect batik account containing Bingo profits. I/ B. Statement of ownership/lease of premises. ~' C. Copies of exempt status from Internal Revenue and Franchise Tax Board ot:.taZc identification number. ~'~'~~~'~ t/ D. Floor plan of room where gaming; will take place showing the exits} Signature of person responsible for Bingo game FEE: $50.00 -General License annual. Over 1{) games. 5.00 -General License each game. Under 10 games. THIS PERMIT IS NONTRANSFERABLE EITiFIER AS TO THE LICENSE OR LOCATION Sheriff recommendation Fire District Health Officer Chief Building Inspector Director of Platming Time of public hearing _ Business License No. FOR OFFIC:[AL USE ONLY YES~NO 1~''~~ ~--~• S~RvINCr"fUN ~S.C.Co.S.a~ YES~_ NO YES •W."rip ^''~--- Vc'{~3AL. Co NFt'R MA-Cti'+J N FRt~ rn YE .NO KEAL~ tNs'PEctD~ c.oC. T'RP.N YES NO Zo-~ Statement Of OwnershiplLease Of Premises St. Joseph of Cupertino 101'10 N. DeAnza Blvd Cupertino, Ca 95014 1-Dec-OS The Santa Clara County Sheriffs Department may inspect the Bingo records of St. Joseph of Cupertino. The premises used for St. Joseph of Cupertino Bingo are owned by the Church/Diocese of San Jose. ,) ~l Ed Ramage Chairman, St Joseph Bingo 20-8 PARISH HALL FLOOR PLAN EXIT S T A G E EXIT B HALL KITCHEN EXIT> ~~ 0 GYM & LARGE HALL EXIT ~~ EXIT SMl PARKING LOT ~~ <Driveway to N.DeAnza Blvd B A N K Driveway to Stevens Creek N O (O