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05b. ABC Sushi Ya Restaurant City Hall ` - 10300 Torre Avenue Cupertino, CA 95014 (408) 777-3212 Ci.~ OF Fax; {408} 777-3366 CUPERTI~10 OFFICE OF THE CITY MANAGER SUMMARY AGENDA ITEM NUMBER ~ ~ AGENDA DATE SUBJECT AND ISSUE Application for Alcoholic Beverage License. BACKGROUI~TD 1. Name of Business: Sushi Ya Restaurant Location: 21265 Stevens Creek Boulevard, Suite 205 Type of Business: Restaurant Type of License: On Sale Beer &Wine-Eating Place (41) Reason for Application: Original & Annual Fees 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: Colin Jun e 'or anner David Knapp, City Manager G:planning/misc/Sushiya 5b - t Prinfarf nn Aar:v~:lr~rf Panar Department of Alcoholic Beverage Control State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE{S) ABC 211 (6199) TO: Department of Alcoholic Beverage Control File Number: 471935 100 Paseo de San Antonio Receipt Number: 1683128 Rm. 119 Geographical. Code: 4303 San Jose, CA 95113 Copies Mailed Date: September 19, 2008 (408)277-1200 Issued pate: DISTRICT SERVING LOCATION: 5AN ,LOSE First Ownel•: SUSHI YA INC Name of Business: SUSHI YA RE,STAURANT Location of Business: 21265 STEVENS CREEK BLVD #205 CUPERTINO, CA 95014-5715 County: SANTA CLARA Is premise inside city limits? Yes Census Tract 5078.05 Mailing Address: (If different from premises address) Type of license(s): 41 Transferor's license/name: / Dropping Partner: Yes No License Ty.~e TransactiQlL Tyke Fee Tvne .Master p.~p Date ~ 4l ON-SALE BEER AND ORIGINAL PEES NA Y 0 0 9 / 19 / 0 8 $300.00 41 ON-SALE BEER AND ANNUAL FEE NA Y 0 09/19/08 $304.00 41 ON-SALE BEER AND FEDERAL FINGERPRINTS NA N 1 0 9 / 19 / 0 8 $24.00 41 ON-SALE BEER AND STATE FWGERPRINTS NA N I 0 9 / 19 / 0 8 $39.00 Total $667.00 Have you ever been convicted of a felony? N o Have you ever violated any provisions of the Alcoholic Beverage •Control Act, or regulations of the Department pertaining to the Act? No Explain any "Yes" answer to the above questions on an attachment which shall be deemed pazt of this application. Applicant agl•ees. (a) that any manager employed in an on-sale licensed premise will have all the qualifications of a licensee, and (b) that he will not violate or cause or permit to be violated any of the provisions of the Alcoholic Beverage Control Act. • STATE OF CALIFORNIA County of SANTA CLARA Date: September 19, 200$ Under penalty of perjury, each person whose signature appears below, certifies and says: (1) He is an applicant, or- one of the applicants, or au executive officer of the applicant corporation, named in the foregoing. application, duly authorized to make this application on its behatf; (2) that he has read the foregoing and knows the contents thereof and thnt each of the above statements therein made are true; (3) that no person other than the applicstnl or applicants has any • direct or indirect interest in the applicttnl or applicant's business to be conducted under the license(s) • for which this application is tnade; (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an agreement entered iuio more than ninety (90) days preceding the day ea which the transfer application is filed with the Department or .to gain or establish a preference to ar For any creditor or transferor or to defirud or injure any creditor of transferor; (5) that Ute transfer application may be ~vithdrawn by either the .applicant or the licensee with na resulting liability to the Department. Applicant Name(s) Applicant S' re(s c__-._~ SUSHI YA INC ~ ~rj 5b-2