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Please provide all information requested; an incomplete application may delay approval <br />FACILITY INFORMATION • <br />Name of Facility: Central Coffee Company <br />Street Address: 624 N Central Ave. <br />City: Tracy Zip Code: 95376 <br />FORMER NAME OF FACILITY • <br />BUSINESS OWNER INFORMATION • <br />Business Owner Name: William Spragge <br />Home Address: 740 Rockport Ct. Tracy CA 95377 <br />Mailing Address: 740 Rockport Ct. Tracy CA 95377 <br />Telephone Number: (925) 399-1717 <br />PROPERTY OW ER FORM , TIO • <br />Property Owner Name:Greg Cose <br />Home Address:2841 Pebblebrooke Ct. Tracy CA 95377 <br />Mailing Address:2841 Pebblebrooke Ct. Tracy CA 95377 <br />Telephone Number: (209) 814-7619 <br />---m-- —.- <br />CONTRACTOR INFORMATION <br />—if- w <br />• <br />Name of General Contractor: CMR Builder <br />Mailing Address:252 W Larch Rd. Tracy CA 95304 <br />Telephone Number: (209) 221-0818 <br />Contact Person on Site: Bruce Russell <br />Site Phone Number: (209) 321-5487 <br />UTILITIES • <br />Source of Facility Water Supply: N/A <br />Backf low Protection: N/A <br />System to be used for Liquid Waste Disposal (Sewage): N/A <br />Solid Waste Disposal to be provided:N/A <br />Grease Interceptor: N/A <br />FOOD INFORMATION • <br />List food(s) to be served and/or provide menu: See attached menu <br />OPERATIONAL INFORMATION • <br />Anticipated Business Hours: Open: 6:30am Close: 8:00pm <br />Anticipated Number of Employees: 10 <br />EHD 16-01 4 PLAN CHECK GUIDE <br />6/28/2022