08a. Simply Thai ABC
CITY"'OF"
CUPEI\1INO
City Hall
10300 Torre A venue
Cupertino, CA 95014
(408) 777-3212
Fax: (408) 777-3366
OFFICE OF THE CITY MANAGER
SUMMARY
AGENDA ITEM NUMBER f l.L
AGENDA DATE 1~/1'-Ol
SUBJECT AND ISSUE
Application for Alcoholic Beverage License.
BACKGROUND
1.
Name of Business:
Location:
Type of Business:
Type of License:
Reason for Application:
Simply Thai
21267 Stevens Creek Blvd., Ste. 340 (Oaks Shopping Center)
Restaurant
On-Sale Beer and Wine for Bona Fide Public Eating Place (41)
Original Fees 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::-
L~-:LL/ ZO~
Ciddy W ordeil, City Planner
~
David W. Knapp, City Manager
8a - 1
Printed on Recycled Paper
Department of Alcoholic Beverage Control
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6/99)
State of California
TO: Department of Alcoholic Beverage Control
100 Paseo de San Antonio
Rm. 119
San Jose; CA 95113
(408)277-1200
DISTRICT SERVING LOCATION: SAN JOSE
A T SIAM LLC
SIMPLY TlIAI
File Number; 455404
Receipt Number: 1619963
Geographical Code: 4303
Copie_s Mailed Date: June 22, 2007
Issued Date:
Fi rst Owner:
Name of Business:
Locati on of Business:
21267 STEVENS CREEK BLVD
STE 340
CUPERTINO, CA 95014-5716
SANTA CLARA
Yes Census Tract 5078.05
County:
Is premise inside city limits?
Mailing Address:
(If different from
premises a.ddress)
15159 MONTALVO RD
SARATOGA, CA 95070
Type of license(s): 41
Tr an sferor; s 1 i cense/n ame:
/
Dropping Partner:
Yes~
NO~
License Type
Transaction Type
Fee Type
NA
NA
NA
Master Dup " Date
y 0 06/22/07
Y 0 06/22/07
N 3 06/22/07
"Total
Fee
41 ON-SALE BEER AND ORIGINAL FEES
41 ON-SALE BEER AND ANNUAL FEE
41 ON"SALE BEER AND STATE FINGERPRINTS
$300.00
$304.00
$117.00
$721.00
Have you ever been convicted of a felony? N 0
Have you ever violated any provisions of the" "Alcoholic Beverage Control Act, or regulations of the
Department pertaining to the -Act? No
Explain any Ity es II. answer to" the above ques ti ons 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 Alcoh_olic Beverage Control Act.
STATE OF CALIFORNIA County of SANTA CLARA Date: June 22,2.007
Under penalty of perjury, each person whose signature appears belowt 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 con tents thereof and that each of the above statements therei n made are tru e; (3) that no person other
than the applicant or applicants has any direct or indirect interest in the applicant or applicant1s business t.o be conducted under the "license(s) 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 lo fulfill an
agreement entered into more than ninety (gO) days preceding the day on which the transfer application is filed 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 eiLher the applicHnt or the licensee with no resulting liability to the Department.
Applicant Name(s)
AT SIAM LLC
'X
.J
Applicant Signat~re(s) 1)/
~ n v . ~Af'JA~~~ ~
Department of Alcoholic Beverage Control
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6/99)
"State of California
TO: Departm~nt of Alcoholic Beverage Control
100 Paseo de San Antonio
Rm. 119
San Jose, CA 95113
( 408)277-"1200
DISTRICT SERVING LOCATION: SAN JOSE
AT SIAM LLC
SIMPLY TIIAI
File Number: 455404
Receipt Number: 1619963
Geographical Code: 4303
Copies Mailed Date: June 22, 2007
Issued Date;
Fi rs t Owner:
Name of Business:
Locuti on of B usi ness:
21267 STEVENS CREEK BLVD
STE 340
CUPERTINO, CA 95014-5716
SANTA CLARA
Coun ty:
Is premise inside city limits?
Mailing Address:
(If different from
premi ses address)
Yes
Census Tract 5078.05
15159 " MONT AL va RD
SARATOGA, CA 95070
Type of license(s): 41
Tr ansferor' s Ii cense/n ame:
/
Dropping Partner:
Yes
NO'~
y
y
N
Dup
o
o
3
Date
06/22/07
06/22/07
06/22/07
Total
Fee
License Type
Transacti on Type
Fee Type
NA
NA
NA
Master
41 ON-SALE BEER AND ORIGINALFEES
41 ON-SALE BEER AND ANNUALFEE
41 ON-SALE BEER AND STATEFINGERPRINTS
$300.00
$304.00
$117.00
$721.00
Have you ever been convicted of a felony? N 0
Have you ever violated any provisions of the Alcoho.1ic Beverage Control Act, or regulations of the
Department pertaining to the Act? No
Explain any UYesl' answer 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: June 22,2007 ,
Under penalty of perjury, each person" whose signature appears belowt certifies and says: (1) He is an applicant, or one of the "applicants, or an
executive officer of the applicant corporation. named in (he 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 Uue~ (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 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 [he transfer application is fUed with the Department or Lo gain or
establish a preference to or for Hny creditor or tl'ansferor or to defraud or injure any creditor of transferor; (5) that the transfer application may
be withdrnwn by eiLher the tlpplicant or the licensee with, no l'esulting liability to the Department
Applicant Name(s) "
ATSIAMLLC
")(
.J
A9P~atV\/L/.
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