09. Alcoholic Beverage License Nutrition RestaurantSUMMARY
AGENDA ITEM NUMBER I
SUBJECT AND ISSUE
Application for Alcoholic Beverage Licens, !.
BACKGROUND
1. Name of Business:
Location:
Type of Business:
Type of License:
Reason for Application:
RECOMMENDATION
AGENDA DATE July 20, 2010
Nutritia-i Restaurant
10935 North Wolfe Road
Restaurant
On -Sale Beer & Wine (41)
Original & Annual fees, State & Federal Fingerprints
There are no use permit restrictions or zoring restrictions which would prohibit this use
and staff has no objection to the issuance c-f the license.
Prepared by:
G pUnning/misglabc Nutrition Restaurant
S-ibmitted by:
David W. Knapp, City Manager
9-1
Department of Alcoholic Beverage Control State of California
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6199)
TO:Department of Alcoholic Beverage Control
100 PASEO DE SAN ANTONIO
ROOM 119
SAN JOSE, CA 95113
(408)277-1200
File Number: 500521
Receipt Number: 2003579
Geographical Code: 4303
Copies Mailed Date: June 15, 2010
Issued Date:
DISTRICT SERVING LOCATION: SAN JOSE
First Owner: NUTRITION RESTAURANT INC
Name of Business: NUTRITION RESTAURANT
Location of Business:
County:
Is Premise inside city limits?
Mailing Address:
(If different from
premises address)
Type of license(s):. 41
Transferor's license/name:
10935 N WOLFE RD
CUPERTINO, CA 95014
SANTA CLARA
Yes
Census Tract 5081.01
Dropping Partner: Yes No X
License Type Transaction Type
Fee Type
Master Dua
Date
Fee
41 - On -sale Beer And Wine ORIGINAL FEES
NA
Y. 0
06/15/10
$300.00
41 - On -Sale Beer And Wine ANNUAL FEE
NA
Y 0
06/15/10
$350.00
NA STATE FINGERPRINTS
NA
N 1
06/15/10
$39.00
NA FEDERAL FINGERPRINTS
NA
N 1
06/15/10
$24.00
Total
$713.00
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 attachment which shall be deemed part ofthis application.
Applicant agrees (a) that any manager employed in an on -sale licensed premises 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: June 15, 2010
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 applicants business to be conducted under the licenses) 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 fled 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 may be withdrawn by either the applicant or the licensee with no resulting liability to the Department.
Applicant Name(s)
Applicant Signature(s)
-NUTRITION RESTAURANT INC �'