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City of Stockton Hotel/Motel Permit to Q[Lerate Apoication <br /> 1. Are you currently or have youe er owned/operated, managed or worked at a hotel, motel <br /> and/or residential hotel/motel? dYes ❑ No <br /> If so, please provide the Following information and answer the following questions <br /> separately for each facility (you may attach an additional sheet of paper if necessary): <br /> Name of facility(s): o <br /> Address of facility(s): <br /> <5')Z)GIG FMI Ccs 2-0 <br /> a How long did you own/operate or work at the facility(;)? 1 (, (_Ys— <br /> v What was your capacity at the facility(s) (i.e., Manager, desk clerk, etc.,)? 0C.kDD w r�wCM0 c V <br /> Was the facility(s) you liste_d above ever cited for health, safety, fire and/or building code 0 <br /> violation(s)? [-]YesNo <br /> If so, were all corrections and/or repairs of those violations completed and approved <br /> within the time required on the citation? []Yes F]No <br /> During your involvement with the facility(s), has there been repeat citations for health, <br /> safety and/or building code violations? ❑Yes �hlo <br /> a In the past five years, has the facility(s) ever been cited for violations, and subsequently <br /> vacated due to corrections/repairs not being completed? []Yes „ No <br /> 2. How many managers do you employ at your facility? � 17?- <br /> 3. In the past three years, have you ever had a Permit to Operate denied, revoked or suspended <br /> within the State of California? D Yes P No <br /> If so, please provide the reason for decrial, revocation and/or suspension and the location <br /> that the permit was denied, revoked and/or suspended: <br /> 4. Have you ever applied for a Permit to Operate using a different name? Ej Yes No <br /> �- If so, please provide the other name: <br /> 5. As the property owner, operator, manager and/or lessee of a hotel/motel, within the last five <br /> years, have you terminated your lease, defaulted on your loan, or otherwise discontinued your <br /> association with the property while violations, as cited in a Notice of Violation, Notice and <br /> Order, Administrative Citation, etc;;., wero stili o-utstatiding? <br /> .^� W,s I,40 <br /> If so, please describe:w <br /> "Fees arcs effective from 0710//2010--06/301202.0 <br />