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City of Stockton Hotel/Motel Permit to Operate Application Page 2 <br /> 1. Are you currently or have you ever owned/operated, managed or worked at a hotel, motel <br /> and/or residential hotel/motel? 0 Yes ❑ 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): �JIW Z ki <br /> Address of facility(s): 4�' j'� jt` i z-y" Ible <br /> • How long did you own/operate or work at the facility(s)? ye"l,5 <br /> • What was your capacity at the facility(s) (i.e., Manager, desk clerk, etc.,)? M�=y <br /> • Was the facility(s) you listed above ever cited for health, safety, fire and/or building code <br /> violation(s)? ❑Yes ErNo <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 ❑,No <br /> • 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? 511= <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? ❑ Yes 'F"! 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 /> 4. Have you ever applied for a Permit to Operate using a different name? ❑ Yes KJ 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., were still outstanding? <br /> ❑ Yes [�] No <br /> If so, please describe: <br /> **Fees are effective from 0710112015—06130/2016 <br />