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City of Stockton Hotel/Motel Permit to Q[Lerate Apoication <br />1 <br />2 <br />3 <br />4 <br />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): <br />Address of facility(s): <br />'5')Z) CIG FMA Ccs q- � 2-0 A�--, <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.,)? QC.kDD w r �wCM0 c Y <br />Was the facility(s) you liste_d above ever cited for health, safety, fire and/or building code <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 [-]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? nYesF,--j-No <br />How many managers do you employ at your facility? <br />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 denial, revocation and/or suspension and the location <br />that the permit was denied, revoked and/or suspended:_- <br /># -lave you ever applied for a Permit to Operate using a different name? Ej Yes [�j 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 loam, 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 1,40 <br />If so, please describe: <br />"Fees arcs effective from 0710//2010 -- 06/301202.0 <br />