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City of Stockton Hotel/Motel Permit to Operate Application Page 2 1. Are you currently or have you ever owned/operated, managed or worked at a hotel, motel and/or residential hotel/motel? Z Yes ❑ No • If so, please provide the following information and answer the following questions separately for each facility (you may attach an additional sheet of paper if necessary): Name of facility(s): ©X 'F -O r-� -H ©—ff— L, Address of facility(s): 5 A U p o K A S`F, s TOC�KTO/J CA 15 a ()a How long did you own/operate or work at the facility(s)? 16 y.,.e a- v-� What was your capacity at the facility(s) (i.e., Manager, desk clerk, etc.,)? Was the facility(s) you listed above ever cited for health, safety, fire and/or building code violations)?,]Yes [:]No ➢ If so, were all corrections and/or repairs of those violations completed and approved within the time required on the citation? tQYes [:]No • During your involvement with the facility(s), has there been repeat citations for health, safety and/or building code violations? ❑Yes XNo In the past five years, has the facility(s) ever been cited for violations, and subsequently vacated due to corrections/repairs not being completed? ❑Yes ®No 2. How many managers do you employ at your facility? Q 3. In the past three years, have you ever had a Permit to Operate denied, revoked or suspended within the State of California? ❑ Yes ® No > If so, please provide the reason for denial, revocation and/or suspension and the location that the permit was denied, revoked and/or suspended: 4. Have you ever applied for a Permit to Operate using a different name? ❑ Yes X No ➢ If so, please provide the other name: 5. As the property owner, operator, manager and/or lessee of a hotel/motel, within the last five years, have you terminated your lease, defaulted on your loan, or otherwise discontinued your association with the property while violations, as cited in a Notice of Violation, Notice and Order, Administrative Citation, etc., were still outstanding? ❑ Yes DNo ➢ If so, please describe: **Fees are effective from 0710112024 — 06130/2025