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10a. Lucy's Cafe I F CUPERJINO City Hall 10300 Torre Avenue Cupertino, CA 95014 (408) 777-3212 p~v· V1r1S1.) 77'7-11';'; OFFICE OF THE CITY MANAGER SUMMARY AGENDA ITEM NUMBER 10 <L SUBJECT AND ISSUE AGENDA DATE November 15.2005 Application for Alcoholic Beverage License. BACKGROUND 1. Name of Business: Location: Type of Business: Type of License: Reason for Application: RECOMMENDATION Lucy's Café 21670 Stevens Creek Boulevard (Formally Tory's Restaurant near the intersection of Stevens Creek Boulevard and Imperial Avenue) Restaurant On-Sale Beer and Wine for Bona Fide Public Eating Place Annual Fees There are no use permit restrictions or zoning restrictions which would prohibit this use and staff has no objection to the issuance ofthe license. Prepared by: ~ 2<J~ Ciddy Worde I, City Planner Submitted by: ~ David W. Knapp City Manager G: IPlanninglMJSCELL IABClabclucyscafe#2. doc Printed on Recycled Paper 100...-1 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 Room 119 San Jose, CA 95113 (408) 277-1200 DISTRICT SERVING LOCATION: File Number: 433422 Receipt Number: 1541524 Geographical Code: 4303 Copies Mailed Date: November 3, 2005 Issued Date: First Owner: Name of Business: SAN JOSE Ll TSUNG YI LUCYSCAFE County: Is premise inside city limitsO Mailing Address: (If different from premises address) 21670 STEVENS CREEK BLVD CUPERTINO, CA 95014 SANTA CLARA Location of Business: Yes Census Tract 5077.01 Type of license(s): 41 Transferor's license/name: License Type Transaction Tyoe / Dropping Partner: Yes_ No Fee Tvpe Master Dup Date Fee NA y 0 11/02/05 $300.00 NA y 0 11/02/05 $304.00 Total $604.00 41 ON-SALE BEER AND ORIGINAL FEES 41 ON·SALE BEER AND ANNUAL FEE 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 of this app\îcation. 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: November 2,2005 Under penalty of perjury, each person whose signature appears below, certifies and says: (I) 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 applicant's business to 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 paymertt 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 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) Ll TSUNG YI Applicant Si nature(s) { D ~- d...