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i City of Stockton Hotel/Motel Permit to Operate Application Page 2 1 . Are you currently or have you eyer owned /operated , managed or worked at a hotel , motel and/or residential hotel/motel ? 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 ) : Address of facility( s ) : � 11 p � u r �F� %0L 0 " • How long did you own/operate or work at the facility( s )? �S • What was your capacity at the facility( s ) ( i . e . , Manager, desk clerk , etc . , ) ? • Was the facility( s ) you liabove ever cited for health , safety, fire and /or building code violation ( s )? ❑Yes ste No If so , were all corrections and /or repairs of those �v9olations completed and approved within the time required on the citation ? Dyes 2 No • During your involvement with the facility( s ) , has tnNo been repeat citations for health , safety and /or building code violations? ❑ Yes • In the past five years , has the facility( s ) ever been cited for viola tio , and subsequently vacated due to corrections/repairs not being completed ? ❑ Yes No 2 . How many managers do you employ at your facility? 3 . In the past three years , have you ever PeNo ermit to Operate denied , revoked or suspended within the State of California ? ❑ Yes 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 JZNo v 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 wo the property while violations , as cited in a Notice of Violation , Notice and Order, AdnP istrative Citation , etc . , were still outstanding ? ❑ YesJ2No If so , please describe : ' Fees are effective from 0710112010 — 06/30/2020