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10a. Wine Delight ABCCity Hall 10300 Torre Avenue Cupertino, CA 95014 {408) 777-3212 Fax: (408) 777-3366 OFFICE OF THE CITY MANAGER SUMMARY AGENDA ITEM NUMBER r ~ ~- SUBJECT AND ISSUE Application for Alcoholic Beverage License. BACKGROUND Name of Business: Location: Type of Business: Type of License: Reason for Application; RECOMMENDATION Wine Delight, LLC 10725 Orline Court AGENDA DATE August 5, 2008 Market Beer & Wine Importer (09), 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 sold. Prepared by: ,, ,-1 ~. , ~ ~ Colin Jung, S for P finer G:planning/misc/abc winedelightLLC Submitted by: David W. Knapp, City Manager 10a-1 Panted on Recycled Paper Department of Alcoholic Beverage Control ~ State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE{S} ABC 21l (6/99) TO: Department of Alcoholic Beverage Control ~ File Number: 4G7G18 100 Paseo de San Antonio Receipt Number: 1G67203 Rm. 119 Geographical Code: 4303 San 3ose, CA 95113 Copies Mailed Date: Jane 3, 2008 (408)277-1200 Issued Date: DISTRICT SERVING LOCATION 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): 09, 17, 20 Transferor's license/name: SAN JOSE WINE DELIGHT LLC WINE DELIGHT LLC 10725 ORLINE CT CUPERTINO, CA 95014-4351 SANTA CLARA Yes Census Tract X~~fj Dropping Partner: Yes . No License Tvne Transaction Type e T e Master Duu at Fee 09 BEER AND WINE IMl DUPLICATE NA N ' 1 0 6 / 0 3 / 0 8 $ 65.00 17 BEER AND WINE WI ORIGINAL FEES NA Y 0 O 6 / 0 3 / O 8 $100.00 i7 BEER AND WINE WI ANNUAL FEE NA Y 0 06/03/08 $269.00 20 OFRSALE BEER ANI ORIGINAL FEES NA Y 0 0 6 / 0 3 / 0 8 $100.00 20 OFF-SALE BEER ANI ANNUAL FEE NA Y 0 0 6 / 0 3 / 0 8 $220.00 20 OFF-SALE BEER ANI STATE FINGERPR)NPS NA N 4 0 6 / 0 310 8 $1$ 6 AO 20 OFF-SALE BEER ANI FEDERAL FINGERPRINTS NA N 4 0 6 / 0 3 / 0 8 $96.00 Total $1,006.00 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" answer to the above questions on an attachirtent 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 3, 2008 finder penalty of perjury, each person whose signature appears below, certifies and says: (1) He is as 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 interrst in the applicant or applicant's business to be conducted under the licenses} for which this application is made; (4) drat 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 [hc 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 tmnsfer application may be withdrawn by either the applicant or the licensee with no resulting liability to the Department. Applicant Name(s) Applicant Signature(s) WINE DELIGHT LLC See 2] 1 Signat ire Page 10a - 2 State of California APPLICATIQN SIGNATURE SHEET ("SIGN ON Department of Alcoholic Beverage Control -- - ---_ • This form is to be used as the signature page for ~' tJwNERSH P ( one applications not signed in the District Office. ("7 Sole Owner ^ Corporation • Read instructions on reverse before completing. ^ Partnership ~ Limited Liability Company • A!! slg»atures must be notarhed in accordance wffh ^ Husband & Wife ^ Other laws of the State where signed ^ Partnership-Ltd 5. APPLICANT(S) NAME (Las4 first, middle) Wine Delight LLC 6. APPUCANT"5 MAILING ADDRESS (Street address/P.O, box, aty, state, rip code) 10725 Online Court, Cupertino, CA 95014 7. PREMISES ADDRESS (Street address, cih/, zip code) 10725 Online Court, Cupertino, CA 95014 APPLICANT'S CERTlFICATlON Under penalty of perjury, each person whose signature appears payment of a loan or to fulfill an agreement entered into more than below, certifies and says: (1) He/she is an applicant, or one of ninety (90) days preceding the day on which the transfer the applicants, or an executive officer of the applicant application is filed with the Department, (b) to ain or establish a corporation, named in the foregoing ap licadon, duly authorized preference to or for any creditor or transferor, or~c) to defraud or to make this application on its behalf; ~l) that he/she has read in3ure any creditor or transferor; (5) that the transffer application the foregoing and knows the contents thereof and that each of [he may be withdrawn by either the applicant or the licensee with no above statements therein made are true; (3) that no person other resulting liability to the Deppartment. than the applicant or appplicants has any direct or indirect interest T understand That if I fail fo qualify for the license or withdraw this in the a Picant or applicant's business to be conducted under the application there will be a service charge of one-fourth of the license~s~ for which this application is made; (4) that the transfer license fee paid, up to $100. application or proposed transfer is not made to (a) satisfy the SOLE OWNER a. PRINTED NAME (Last, Nrsl, middle) SIGNATURE GATE SIGNED X PARTNERSHIP/LIMITED PARTNERSHIP (Signatures of general partners only) 9. PARTNER'S PRINTED NAME (Last drs4 mWde) SIGNATURE DATE SIGNED X PARTNER'S PRINTED NAME {Lest, first middle) SIGNATURE DATE SIGNED X PARTNER'S PRINTED NAME (Last, flrs4 midrBa) SIGNATURE DATE SIGNED X CORPORATION i0. PRINTED NAME (Last, first, middle) SIGNATURE DATE SK3NED I ~ X _ TITLE ^ President ^ Vice President ^ Chairman of the Board PRINTEp NAME (last, ~, middle) SIGNATURE DATE SIGNED X TITLE ^ Secretary ^ Asst. Secretary ^ Chief Financial Officer ^ Asst. Treasurer LIMITED LIABILITY COMPANY 11. The limited liability company is member-run Q Yes ^ No (If no, complete Item #12 below) t2 NAME OF DESIGNATED MANAGER, MANAGING MEMBER OR DESIGNATED OFFICER (Last rest, middle) ABC INITIALS/DATE (ABCrueonly) 13 MEMBER'S PRINTED NAME (Last. first, nwddle) SIGNA DATE SIGNED Pillet, Bruno ~OLLt X ~... - ~ ~ - Z MEMBER'S PRINTED NAM (LEI, first, mlddla) SIGNATURE DATE SIGNED `` / ry Yap, Polly y l h W R X c~.~~ fT }--! !t d ABC-211-SIG (2/03 "SIGN dN" 2. f7LE NLIMaER {N any) 3. LICENSE TYPE 4. TRANSACTION TYPE ~ Original ^ Person to Person Transfer ^ Exchange ^ Premise to Premise Transfer 20, 17, 9 ^ Other 10a-3 CALfFO~iNfA ALL-PURP~SL ACKNQWLEDCWIENT -State of California County of SQ,~- GI ttna- On ~,,~...a. ~`'I a0og ' before rrte, ,~r.1~~ 1G Pa,~e.P, v>,o•-~r+1 ~uk,.~rG paw ~ Hera Insert Name an Trite the fkcer personally appeared I3~1-•1t:J ~. Q 1 Li_~ ~~ k~ec5> ~ st~a~ - ~ ppfCSHA K. PATEL ~~- Commission # 1575295 ~ Notary Public - Ca~fomla n Santa Clara County My Comm. FxpireS N1o1' 2~ 2009 who proved-to me on the basis of satisfactory evidence to be the person®) whose name{} ii~/are subscribed to the within instrument and acknowledged to me that he/they executed the same in las~el'/their authorized -capadtyf~j, and that by fir/their signature on the instrument the .person, or the entity upon Behalf of which the person) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ' WETNESS my hand and official se Signature Place tdolary Seal Above ~ Signetwe o1 otary P 'e OPTIONAL . Though the information below is nat requJrecl by law, if may prove vatuable fo persons retying on the document and could prevent fraudulent removal and reattachment of this form to another documenC Description of •Attacihed Document ~ ~ ~ ' ~ . Si - Si.,Q2~" /~L-2 ~ ! -SICK Title or Type of Document: ~ p~~+,C~.AI= ~' ~ 1. ~ - ~ - - Document Date: ~ Number of:Pages: Z Signer(s) Other Than Named Above: ~~ Capacity{ies) Claimed ~by Signer(s) Signer's Name: ^ Individual D Corporate Officer -Title(s): _ D Parfier - D Limited 'D General ^ Attomey in Fact ^ Trustee , ^ ^ 'Guardian or Conservator Other: Signer is Representing: -Top of thumb here Tap of th urr~ here , &~2007NaSa~alt~ryAss~iafan•1135017aSOtoAve.,P.O.Box2402•Chatsurorih,CA9i313~2402•www.-~tionalNdary,org 1temR5807 Reader.CaATdI-Keel-800-876.6627 Signers Name: ~ Individual -~ - gCorporate Officer -Title(s): D Partner,.- O"Limited ^ General O Attorney in. Fact . ~ ~ ~ • D Trustee • ~ ' ^ Guardian or Conservator D Other: Signer Is Representing: 10a-4